The American journal of medicine
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Review Meta Analysis
Milk thistle for the treatment of liver disease: a systematic review and meta-analysis.
Milk thistle, an herbal compound, is the dietary supplement taken most frequently by patients with chronic liver disease. We performed a systematic review of the literature to determine the efficacy and safety of this herb for the treatment of liver disease. ⋯ Treatment with milk thistle appears to be safe and well tolerated. We found no reduction in mortality, in improvements in histology at liver biopsy, or in biochemical markers of liver function among patients with chronic liver disease. Data are too limited to exclude a substantial benefit or harm of milk thistle on mortality, and also to support recommending this herbal compound for the treatment of liver disease.
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To determine whether nosocomial candidemia is associated with increased mortality in intensive care unit (ICU) patients. ⋯ Nosocomial candidemia does not adversely affect the outcome in ICU patients in whom mortality is attributable to age, the severity of underlying disease, and acute illness.
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To estimate the cost-effectiveness of gastric bypass in the treatment of severe obesity. ⋯ Gastric bypass is a cost-effective alternative to no treatment, providing substantial lifetime benefits in patients who are severely obese.
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Multicenter Study
Syncope in acute aortic dissection: diagnostic, prognostic, and clinical implications.
Syncope is a well-recognized symptom of acute aortic dissection, often indicating the development of dangerous complications such as cardiac tamponade. ⋯ Patients with dissections complicated by cardiac tamponade or stroke are significantly more likely to present with syncope. If these complications are excluded, syncope alone does not appear to increase the risk of death independently.