The New England journal of medicine
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Clinical Trial
Improvement in pulmonary function and elastic recoil after lung-reduction surgery for diffuse emphysema.
Pulmonary function may improve after surgical resection of the most severely affected lung tissue (lung-reduction surgery) in patients with diffuse emphysema. The basic mechanisms responsible for the improvement, however, are not known. ⋯ Lung-reduction surgery can produce increases in the elastic recoil of the lung in patients with diffuse emphysema, leading to short-term improvement in dyspnea and exercise tolerance.
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Randomized Controlled Trial Comparative Study Clinical Trial
A randomized comparison of antiplatelet and anticoagulant therapy after the placement of coronary-artery stents.
The clinical benefit of coronary-artery stenting performed in conjunction with coronary angioplasty is limited by the risk of thrombotic occlusion of the stent as well as hemorrhagic and vascular complications of intensive anticoagulation. We compared antiplatelet therapy with conventional anticoagulant therapy with respect to clinical outcomes 30 days after coronary-artery stenting. ⋯ As compared with conventional anticoagulant therapy, combined antiplatelet therapy after the placement of coronary-artery stents reduces the incidence of both cardiac events and hemorrhagic and vascular complications.
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Several surgical procedures to treat trigeminal neuralgia (tic douloureux) are available, but most reports provide only short-term follow-up information. ⋯ Microvascular decompression is a safe and effective treatment for trigeminal neuralgia, with a high rate of long-term success.
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Randomized Controlled Trial Comparative Study Clinical Trial
Induction of labor compared with expectant management for prelabor rupture of the membranes at term. TERMPROM Study Group.
As the interval between rupture of the fetal membranes at term and delivery increases, so may the risk of fetal and maternal infection. It is not known whether inducing labor will reduce this risk or whether one method of induction is better then another. ⋯ In women with prelabor rupture of the membranes at term, induction of labor with oxytocin or prostaglandin E2 and expectant management result in similar rates of neonatal infection and cesarean section. Induction of labor with intravenous oxytocin results in a lower risk of maternal infection than does expectant management. Women view induction of labor more positively than expectant management.
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Comment Letter Comparative Study
Reanalysis of a trial comparing total mastectomy with lumpectomy.