JAMA : the journal of the American Medical Association
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To estimate the relations between established cardiovascular risk factors and total homocysteine (tHcy) in plasma. ⋯ Elevated plasma tHcy level was associated with major components of the cardiovascular risk profile, ie, male sex, old age, smoking, high blood pressure, elevated cholesterol level, and lack of exercise. These findings should influence future studies on the etiology and pathogenesis of cardiovascular disease.
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Practice Guideline Guideline
Dehydration. Evaluation and management in older adults. Council on Scientific Affairs, American Medical Association.
To review published literature regarding dehydration in older individuals and formulate a consensus on the evaluation and treatment of this unrecognized cause of hospitalizations, morbidity, and mortality. ⋯ Early diagnosis is sometimes difficult because the classical physical signs of dehydration may be absent or misleading in an older patient. Many different etiologies place the elderly at particular risk. In patients identified as being at risk for possible dehydration, an interdisciplinary care plan with regard to prevention of clinically significant dehydration is critical if maximum benefit is to result.
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To examine the limits of the effectiveness of critical care through the study of patients for whom it was ineffective. ⋯ Patients in the PIC category consumed a large portion of the resources devoted to critical care at an academic teaching hospital. We suggest a change in focus from assessment of the quality of critical care and risk-adjusted mortality to an assessment of ineffective care based on outcome and resource use and a patient's response to treatment over time.
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Editorial Comment
Mental disorders. Quality of life and inequality of insurance coverage.