The New England journal of medicine
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Randomized Controlled Trial Clinical Trial
Cyclooxygenase inhibitors and the antiplatelet effects of aspirin.
Patients with arthritis and vascular disease may receive both low-dose aspirin and other nonsteroidal antiinflammatory drugs. We therefore investigated potential interactions between aspirin and commonly prescribed arthritis therapies ⋯ The concomitant administration of ibuprofen but not rofecoxib, acetaminophen, or diclofenac antagonizes the irreversible platelet inhibition induced by aspirin. Treatment with ibuprofen in patients with increased cardiovascular risk may limit the cardioprotective effects of aspirin.
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Multicenter Study
Recurrent cerebrovascular events associated with patent foramen ovale, atrial septal aneurysm, or both.
Patent foramen ovale and atrial septal aneurysm have been identified as potential risk factors for stroke, but information about their effect on the risk of recurrent stroke is limited. We studied the risks of recurrent cerebrovascular events associated with these cardiac abnormalities. ⋯ Patients with both patent foramen ovale and atrial septal aneurysm who have had a stroke constitute a subgroup at substantial risk for recurrent stroke, and preventive strategies other than aspirin should be considered.
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In adults with suspected meningitis clinicians routinely order computed tomography (CT) of the head before performing a lumbar puncture. ⋯ In adults with suspected meningitis, clinical features can be used to identify those who are unlikely to have abnormal findings on CT of the head.