Journal of general internal medicine
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Comparative Study Clinical Trial Controlled Clinical Trial
Effects of diet and exercise interventions on control and quality of life in non-insulin-dependent diabetes mellitus.
Evidence suggests that diet and exercise are associated with improved glucose tolerance for patients with non-insulin-dependent diabetes mellitus (NIDDM). Seventy-six volunteer adult patients with NIDDM were each assigned to one of four programs: diet, exercise, diet plus exercise, or education (control). Each program required ten weekly meetings. ⋯ In addition, this group showed significant improvements on a general quality of life measure. These improvements were largely uncorrelated with changes in weight. The authors conclude that the combination of dietary change and physical conditioning benefits NIDDM patients, and that the benefits may be independent of substantial weight loss.
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Funding for medical care research in the interrelated fields of health services research, clinical decision-making, clinical epidemiology, the medical humanities and social sciences, and medical education has been unstable, and relatively little is available in the form of investigator-initiated grants. Stable funding for these fields is important to society and critical to the healthy development of academic general internal medicine. ⋯ Public funding is also needed for career development awards in these fields. Research support also could be enhanced by establishing a consortium of foundations interested in funding investigator-initiated grants through open competition, by developing a mechanism for reviewing proposals from small foundations, by developing consortia in the private sector to support focused research, and by developing endowments to support research.
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To assess the risk of mortality in patients with hyponatremia at the time of hospital admission, the authors studied data for 13,979 patients admitted over a 46-month period. Of the 763 (4%) admitted with hyponatremia, 757 (99%) were matched by age, gender, and admitting date with normonatremic control patients. ⋯ This relationship with in- and outpatient mortality held when controlling for the diagnoses found more often in the hyponatremic patients. Hyponatremia appears to be an indicator of increased risk of death regardless of the disease with which it is associated.