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This randomized, controlled trial compared standard renal-replacement therapy with more intensive therapy in critically ill patients with acute kidney injury and failure of at least one nonrenal organ or sepsis. Intensive renal support did not decrease mortality, improve recovery of kidney function, or reduce the rate of nonrenal organ failure as compared with thrice-weekly intermittent hemodialysis.
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In this clinical trial, a combination of epinephrine plus vasopressin was compared with epinephrine alone in out-of-hospital cardiopulmonary resuscitation. There was no benefit from the addition of vasopressin, and on the basis of these findings, this agent cannot be recommended in this clinical setting.
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This phase 2 trial investigated the efficacy of motesanib diphosphate, an orally active inhibitor of VEGF receptors, in patients with advanced differentiated thyroid cancer. None of the patients had had a response to conventional treatment. No patient had a complete response, but 14% had a partial response, with a median duration of 32 weeks. Motesanib diphosphate is an option for patients with metastatic or locally progressive differentiated thyroid cancer who have not had a response to usual treatment.
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Endomyocardial fibrosis is the most common cause of restrictive cardiomyopathy worldwide and in its advanced stages has a poor prognosis. This study used echocardiographic screening for endomyocardial fibrosis in Mozambique and found a prevalence of nearly 20%, much of which was mild to moderate in severity. These data may help to develop therapeutic or preventive approaches.
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This national survey finds that only 4% of physicians use an extensive, fully functional system for electronic health records, and 13% use some form of basic electronic records. Those who use electronic records are generally satisfied with the systems and believe that they improve the quality of care that patients receive.
Many lines of evidence, including epidemiologic data and extensive clinical and experimental studies, indicate that early life events play a powerful role in influencing later susceptibility to certain chronic diseases. This review synthesizes evidence from several disciplines to support the contention that environmental factors acting during development should be accorded greater weight in models of disease causation.
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