Prophylaxis of Thromboembolism in Critical Care (PROTECT) Trial: a pilot study.

Purpose: There is no randomized trial comparing low-molecular weight heparin (LMWH) and unfractionated heparin (UFH) for thromboprophylaxis in medical-surgical ICU patients. The primary objective of this randomized pilot study on LMWH vs UFH was to assess the feasibility of conducting a large randomized trial with respect to timely enrollment and blinded study drug administration, practicality of twice-weekly lower limb ultrasounds to screen for deep venous thrombosis, LMWH bioaccumulation and dose adjustment in renal insufficiency, and recruitment rates for a future trial in medical-surgical intensive care unit (ICU) patients. Its additional goals were to evaluate the suitability of the exclusion criteria and to document the range of research activities that precede accrual of patients into a trial to plan multisite management.

Testicular torsion revisited.

Ultrasound is routinely used for the assessment and diagnosis of testicular torsion. It has proven to be a reliable and necessary diagnostic tool for the urologist. Problems, however, can arise in the form of misdiagnosis when the basic pathophysiology and clinical presentation of testicular torsion are not clearly understood.

Ultrasound of the carotid arteries: a pictorial review.

Stroke secondary to atherosclerotic disease remains one of the leading causes of death. Ischemia from severe, flow limiting stenosis due to atherosclerotic disease involving the extracranial carotid arteries is implicated in approximately 20-30% of strokes. An estimated 80% of strokes are thromboembolic in origin, often with carotid plaque as the embolic source, usually involving the internal carotid artery within 2 cm of the carotid bifurcation.

Do sick newborn infants benefit from participation in a randomized clinical trial?

Background: Adult participants in randomized controlled trials often have better outcomes than patients who are eligible but not enrolled.

Objective: To examine whether newborn infants who were allocated to placebo in an investigational drug trial had better outcomes than infants who were eligible but not randomized (eligible NR).

Study Design: During a randomized controlled trial of antithrombin therapy in premature infants with respiratory distress syndrome, data were collected prospectively on all 76 infants in the eligible NR group.