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document
Fat embolism prophylaxis with corticosteroids . A prospective study in high-risk patients . The efficacy of corticosteroid treatment in the prophylaxis of the fat embolism syndrome was evaluated in a prospective , randomized , double-blind study of high-risk patients with long-bone fractures . Using a set of objective diagnostic criteria , we saw a significant difference in the incidence of the syndrome between corticosteroid- ( 0 of 21 ) and placebo-treated patients ( 9 of 41 ) ( p less than 0.05 ) . There were no complications related to corticosteroid treatment . No routine laboratory or physical findings reliably predicted the development of the fat embolism syndrome except petechial rash , which occurred only in 5 placebo-treated patients who developed the syndrome . Complement activation was present in all patients studied who had the syndrome ( 5 of 27 ) but also in many patients who did not meet our diagnostic criteria , suggesting a multifactorial cause . These data support the prophylactic value of corticosteroid treatment in patients at high risk for the fat embolism syndrome , particularly if several unfavorable predictors are present .
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Intervention_Pharmacological
corticosteroids .
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Intervention_Pharmacological
corticosteroid
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Intervention_Pharmacological
corticosteroid-
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Intervention_Control
placebo-treated
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Intervention_Pharmacological
corticosteroid
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Intervention_Pharmacological
corticosteroid
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Outcome_Other
efficacy
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Outcome_Physical
fat embolism syndrome
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Outcome_Physical
syndrome
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Outcome_Physical
development of the fat embolism syndrome
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Outcome_Adverse-effects
petechial rash
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Outcome_Physical
Complement activation
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Outcome_Physical
fat embolism syndrome
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Participant_Condition
fat embolism syndrome
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Participant_Condition
high-risk patients with long-bone fractures .
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Participant_Condition
patients at high risk for the fat embolism syndrome