JAMA : the journal of the American Medical Association
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Randomized Controlled Trial Clinical Trial
Prophylactic treatment of migraine with an angiotensin II receptor blocker: a randomized controlled trial.
There is a paucity of effective, well-tolerated drugs available for migraine prophylaxis. ⋯ In this study, the angiotensin II receptor blocker candesartan provided effective migraine prophylaxis, with a tolerability profile comparable with that of placebo.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Treatment of antidepressant-associated sexual dysfunction with sildenafil: a randomized controlled trial.
Sexual dysfunction is a common adverse effect of antidepressants that frequently results in treatment noncompliance. ⋯ In our study, sildenafil effectively improved erectile function and other aspects of sexual function in men with sexual dysfunction associated with the use of SRI antidepressants. These improvements may allow patients to maintain adherence with effective antidepressant treatment.
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Although few patients with acute abdominal pain will prove to have cholecystitis, ruling in or ruling out acute cholecystitis consumes substantial diagnostic resources. ⋯ No single clinical finding or laboratory test carries sufficient weight to establish or exclude cholecystitis without further testing (eg, right upper quadrant ultrasound). Combinations of certain symptoms, signs, and laboratory results likely have more useful LRs, and presumably inform the diagnostic impressions of experienced clinicians. Pending further research characterizing the pretest probabilities associated with different clinical presentations, the evaluation of patients with abdominal pain suggestive of cholecystitis will continue to rely heavily on the clinical gestalt and diagnostic imaging.
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Concern has been raised about possible increases in the prevalence of autism. However, few population-based studies have been conducted in the United States. ⋯ The rate of autism found in this study was higher than the rates from studies conducted in the United States during the 1980s and early 1990s, but it was consistent with those of more recent studies.