The American journal of medicine
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To examine the effects of cigarette smoking and smoking cessation on the risk of hip fracture in women. ⋯ Smokers are at increased risk of hip fracture and their risk rises with greater cigarette consumption. Risk declines among former smokers, but the benefit is not observed until 10 years after cessation. Both the increased risk among current smokers and the decline in risk after smoking cessation are in part accounted for by differences in body weight.
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To evaluate the performance of a previously validated prediction rule for patients presenting to the emergency department with chest pain and the potential impact of the rule on triage decisions. ⋯ This independent validation of the prediction rule suggests that it can improve triage decisions for patients admitted with suspected acute ischemic heart disease. Additional studies are needed to test prospectively the performance of the prediction rule in actual decision making, its acceptance by clinicians, and its cost effectiveness.
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Randomized Controlled Trial Clinical Trial
Long-term maintenance of weight loss after a very-low-calorie diet: a randomized blinded trial of the efficacy and tolerability of sibutramine.
Very-low-calorie diets are a well established method to achieve substantial short-term weight loss in obese patients, but long-term maintenance of the weight loss is very disappointing. A combined very-low-calorie diet and pharmacologic approach could be an effective means of prolonging its benefits. ⋯ Following a very-low-calorie diet, sibutramine is effective in maintaining and improving weight loss for up to 1 year.
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We sought to survey residents' perceptions regarding the In-Training Examination in Internal Medicine and to assess the ability of faculty members to evaluate the knowledge base of internal medicine residents. ⋯ Residents believe that the In-Training Examination is useful and frequently initiate educational interventions based on results. Faculty and residents lack the ability to evaluate accurately the knowledge of trainees that they supervise. In particular, both groups may be unable to identify trainees who are deficient in this element of clinical competence.
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We sought to identify admission characteristics predicting mortality in elderly patients hospitalized with community-acquired pneumonia and to develop a prognostic staging system and discriminant rule. ⋯ Elderly patients with community-acquired pneumonia have characteristics at admission that can predict mortality. Our staging system and discriminant rule improve prognostic stratification of these patients.