The American journal of medicine
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Randomized Controlled Trial Clinical Trial
A randomized trial of a primary care-based disease management program to improve cardiovascular risk factors and glycated hemoglobin levels in patients with diabetes.
To assess the efficacy of a pharmacist-led, primary care-based, disease management program to improve cardiovascular risk factors and glycated hemoglobin (A(1C)) levels in vulnerable patients with poorly controlled diabetes. ⋯ Our comprehensive disease management program reduced cardiovascular risk factors and A(1C) levels among vulnerable patients with type 2 diabetes and poor glycemic control.
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Staphylococcus aureus is a common cause of bacteremia and of native valve infective endocarditis. However, the risk of endocarditis in patients with a prosthetic valve who develop S. aureus bacteremia is unclear. The aim of this study was to define the risk of prosthetic valve endocarditis in patients with S. aureus bacteremia. ⋯ In this investigation, approximately half of all patients with prosthetic valves who developed S. aureus bacteremia had definite endocarditis. The risk of endocarditis was independent of the type, location, or age of the prosthetic valve. The mortality of prosthetic valve endocarditis is high. All patients with a prosthetic valve who develop S. aureus bacteremia should be aggressively screened and followed for endocarditis.
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Multicenter Study
The incidence of adverse drug events in two large academic long-term care facilities.
To assess the incidence of and risk factors for adverse drug events in the long-term care setting. ⋯ Our findings reinforce the need for a special focus on the ordering and monitoring stages of pharmaceutical care for preventing adverse drug events in the long-term care setting. Patients taking antipsychotic agents, anticoagulants, diuretics, and antiepileptics are at increased risk.
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We investigated the prevalence and clinical importance of cardiovascular abnormalities in patients with hyperthyroidism. ⋯ In patients with hyperthyroidism, there is a high prevalence of pulmonary hypertension and atrioventricular valve regurgitation. These abnormalities usually correct after treatment for hyperthyroidism.
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Respiratory failure is the leading cause of death among patients admitted with community-acquired pneumonia. We sought to determine the association between arterial carbon dioxide tension (P(a)CO(2)) and in-hospital mortality in patients admitted with pneumonia. ⋯ Among patients admitted with community-acquired pneumonia, in-hospital mortality was greater in those with hypocapnia or hypercapnia. These data suggest that measurement of P(a)CO(2) adds prognostic information to standard prediction rules and should be used for clinical and epidemiologic purposes to risk-stratify in-hospital patients with community-acquired pneumonia.