Journal of internal medicine
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The objective was to review the current status of meta-analysis, the process of combining the results of similar investigations, which was described in 1976. It has evolved rapidly, and thousands have already been published. Meta-analysis may be performed in a narrative form or in the preferred statistical format, which is more rigorous and demanding. ⋯ Examples are given from my own field--hepatology--and from my own research experience. Although meta-analysis is simple in concept, it is complex in execution. If performed with insufficient insight or attention to detail, it may give ambiguous or erroneous results.
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Cranial CT scans are amongst the most frequently performed radiological investigations performed in most developed countries. However, these tests are relatively expensive and economic realities should compel physicians to re-evaluate the utilization of this technology. The aim of this study was to review the utilization pattern and effect on management decisions of cranial CT scanning. ⋯ In this study cranial CT scanning affected clinical management decisions in less than half of the patients. Furthermore, a careful history and neurological examination was performed in the minority of patients undergoing CT scanning. It would therefore appear that the easy accessability of CT scans largely determines the utilization of this diagnostic tool.
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Hereditary angio-oedema (C1-inhibitor deficiency) is a disease with protean manifestations which is often misdiagnosed initially. The purpose of this study was to delineate the clinical spectrum and course of this potentially life-threatening disease. ⋯ Hereditary angio-oedema is an autosomal dominant disease with great variability of clinical expression and severity, even within a single kindred. It often goes unrecognized over years, and it may lead to death if, in case of impending airway obstruction, specific therapy is not instituted.
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To investigate calcium intake and its association with bone mineral density (BMD) and the type and extent of the disease in patients with inflammatory bowel disease (IBD). ⋯ Calcium intakes below the recommendations are seen more often in the IBD patients than in the healthy controls, but in the IBD patients the calcium intake is not associated with BMD in a cross-sectional study. A low-lactose diet is common among IBD patients. To reduce the risk of inadequate calcium intake, unnecessary dietary restrictions concerning, e.g. milk products, should be avoided for these patients.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
A multicentre comparison of once-daily subcutaneous dalteparin (low molecular weight heparin) and continuous intravenous heparin in the treatment of deep vein thrombosis.
To compare the efficacy and safety of the low molecular weight heparin (LMWH) dalteparin with unfractionated heparin (UFH) in the acute treatment of DVT patients who had not previously received UFH. ⋯ Fixed-dose subcutaneous dalteparin given once daily from the start of treatment is of equivalent efficacy and safety to conventional UFH therapy in the routine management of DVT.