There was no significant between-group difference in systolic blood pressure the decrease in diastolic blood pressure was smaller in the revascularization group than in the medical-therapy group. Over the same time, the mean serum creatinine level was 1.6 micromol per liter (95% CI, -8.4 to 5.2 ) lower in the revascularization group than in the medical-therapy group. The median follow-up was 34 months.ĭuring a 5-year period, the rate of progression of renal impairment (as shown by the slope of the reciprocal of the serum creatinine level) was -0.07x10(-3) liters per micromole per year in the revascularization group, as compared with -0.13x10(-3) liters per micromole per year in the medical-therapy group, a difference favoring revascularization of 0.06x10(-3) liters per micromole per year (95% confidence interval, -0.002 to 0.13 P=0.06).
Secondary outcomes were blood pressure, the time to renal and major cardiovascular events, and mortality. The primary outcome was renal function, as measured by the reciprocal of the serum creatinine level (a measure that has a linear relationship with creatinine clearance). In a randomized, unblinded trial, we assigned 806 patients with atherosclerotic renovascular disease either to undergo revascularization in addition to receiving medical therapy or to receive medical therapy alone. Scoring wise I think it's deserving of at least one star more than it's current 4.5, more like +1.5, for an all-round 6/10.Percutaneous revascularization of the renal arteries improves patency in atherosclerotic renovascular disease, yet evidence of a clinical benefit is limited. That said, whist its conceptual strengths might not have been fully realised, overall I was impressed and I willl definately keep an eye out for whatever the brothers' Mul come up with next. Someone more suitable could've played a pivotal role in the final act, adding much needed texture, suspense and context. Again, I felt the clairvoyant was cast way too young. The pacing was the other thing which I felt could've been greatly improved upon, particularly the second act which dragged on immeasureably longer than its 40 or so minutes and ate into what should've been a longer, richer and more detailed final show-down. kudos to whoever snagged that beautiful off-term college for your set! A post-graduate/academia centric cast would still have worked in situ, but been more credible somehow. Where I thought things came unstuck was the acting which I found wooden and transparent, pretty much all round, and the casting of far too young protagonsits, This kind of film/script screams 'It's for Grown-Ups!' so having a teenage student ensemble nearly ruined it for me. The script was well written and the film was beautifully shot/directed, despite what I suspect was a small budget, not that it was often evident in the production. There's a lot to like about this film, the premise is excellent and being a fan of the more theological/occultist area of the genre, it was refreshing to come across something possissing origianlity and quality.
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