JAMA : the journal of the American Medical Association
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Randomized Controlled Trial Multicenter Study Clinical Trial
Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results From the Women's Health Initiative randomized controlled trial.
Despite decades of accumulated observational evidence, the balance of risks and benefits for hormone use in healthy postmenopausal women remains uncertain. ⋯ Overall health risks exceeded benefits from use of combined estrogen plus progestin for an average 5.2-year follow-up among healthy postmenopausal US women. All-cause mortality was not affected during the trial. The risk-benefit profile found in this trial is not consistent with the requirements for a viable intervention for primary prevention of chronic diseases, and the results indicate that this regimen should not be initiated or continued for primary prevention of CHD.
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Multicenter Study
Menopausal hormone replacement therapy and risk of ovarian cancer.
The association between menopausal hormone replacement therapy and ovarian cancer is unclear. ⋯ Women who used estrogen-only replacement therapy, particularly for 10 or more years, were at significantly increased risk of ovarian cancer in this study. Women who used short-term estrogen-progestin-only replacement therapy were not at increased risk, but risk associated with short-term and longer-term estrogen-progestin replacement therapy warrants further investigation.
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Emergency department (ED) physicians often are uncertain about where in the hospital to triage patients with suspected acute cardiac ischemia. Many patients are triaged unnecessarily to intensive or intermediate cardiac care units. ⋯ Use of the clinical decision rule had a favorable impact on physicians' hospital triage decisions. Efficiency improved without compromising safety.
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Commercial filming of patient care activities is common in hospital settings. This article reviews common circumstances in which patients are commercially filmed, explores the potential positive and negative aspects of filming, and considers the ethical and legal issues associated with commercial filming of patients in hospital settings. We examine the competing goals of commercial filming and the duties of journalists vs the rights of patients to privacy. Current standards and recommendations for commercial filming of patient care activities are reviewed and additional recommendations are offered.