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To the editor: The paper by Herlong and colleagues (1), published in the October 1980 issue, deserves critical remarks. The study of only 13 patients with such an unstable disorder as hepatic encephalopathy needed a very well-planned design and appropriate statistical methods to draw such clear-cut inferences.
Study 1 is presented as a double-blind crossover trial designed to compare ornithine salts of branched-chain ketoacids (Orn BCKA) to the corresponding branched-chain amino acids (RCAA). In fact, two patients only (out of 13) received the branched-chain amino acids as the first treatment, and eight patients only were given the second treatment. Thus,
MOLIMARD R. Ketoacid Salts in Portal-Systemic Encephalopathy. Ann Intern Med. ;95:521–522. doi: 10.7326/0003-4819-95-4-521_2
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Published: Ann Intern Med. 1981;95(4):521-522.
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