The American journal of medicine
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Randomized Controlled Trial
Activating peripheral arterial disease patients to reduce cholesterol: a randomized trial.
Peripheral arterial disease patients are less likely than other high-risk patients to achieve ideal low-density lipoprotein (LDL) cholesterol levels. This randomized controlled trial assessed whether a telephone counseling intervention, designed to help peripheral arterial disease patients request more intensive cholesterol-lowering therapy from their physician, achieved lower LDL cholesterol levels than 2 control conditions. ⋯ Telephone counseling that helped peripheral arterial disease patients request more intensive cholesterol-lowering therapy from their physician achieved greater LDL cholesterol decreases than an attention control arm that provided health information alone.
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Randomized Controlled Trial Multicenter Study
Use of a decision aid to improve treatment decisions in osteoporosis: the osteoporosis choice randomized trial.
Poor adherence to therapy, perhaps related to unaddressed patient preferences, limits the effectiveness of osteoporosis treatment in at-risk women. A parallel patient-level randomized trial in primary care practices was performed. ⋯ A decision aid improved the quality of clinical decisions about bisphosphonate therapy in at-risk postmenopausal women, did not affect start rates, and may have improved adherence.
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Since the discovery of endothelial progenitor cells in 1997, the scientific world has seen their ups and downs. There has been much discussion about the detection methods of endothelial progenitor cells and their diagnostic and predictive value. ⋯ Now it is time for a change: Most of the controversies have been eliminated by elaborate studies. This review aims to give an overview to the clinically working physician about the measurement, diagnostic potential, predictive value, and therapeutic potential of endothelial progenitor cells.
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Reversal of overanticoagulation to minimize the bleeding risk is important in elderly inpatients receiving vitamin K antagonist therapy. However, no study has specifically focused on this population. The objective of this study is to evaluate whether guidelines based on American College of Chest Physicians recommendations for the management of overanticoagulation (international normalized ratio [INR] ≥5.0) can apply to elderly inpatients, and notably allow 24-hour INRs to return to the 1.8-3.2 range in this population. The influence of different factors on the vitamin K response also was evaluated. ⋯ In elderly inpatients with INR ≥5.0, both vitamin K antagonist dose omission and vitamin K1 administration according to recommendations were effective in reversing overanticoagulation, allowing most INRs to return to the 1.8-3.2 range without excessive overcorrection. Therefore, American College of Chest Physicians recommendations may be applied to elderly inpatients.