Annals of internal medicine
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Effective July 1997, the American Board of Internal Medicine (ABIM) established a research pathway to certification to encourage research training of general internists and subspecialists. ⋯ Few internal medicine subspecialty programs are currently designed to provide adequate research training as defined by the Institute of Medicine and the ABIM.
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Randomized Controlled Trial Clinical Trial
Videotape-based decision aid for colon cancer screening. A randomized, controlled trial.
Rates of colon cancer screening in the United States are low, in part because of poor communication between patients and providers about the availability of effective screening options. ⋯ A decision aid consisting of an educational video, brochure, and chart marker increased ordering and performance of colon cancer screening tests.
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Review Meta Analysis
Osteoarthritis: new insights. Part 2: treatment approaches.
Osteoarthritis is the most common form of arthritis, affecting millions of people in the United States. It is a complex disease whose etiology bridges biomechanics and biochemistry. Evidence is growing for the role of systemic factors, such as genetics, diet, estrogen use, and bone density, and local biomechanical factors, such as muscle weakness, obesity, and joint laxity. ⋯ Part 2 focuses on treatment approaches; evidence for the efficacy of commonly used oral therapies is reviewed and information on alternative therapies, including nutriceuticals and acupuncture, is presented. Biomechanical interventions, such as exercise and bracing, and behavioral interventions directed toward enhancing self-management are reviewed. Current surgical approaches are described and probable future biotechnology-oriented approaches to treatment are suggested.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Comparison of oral fluconazole and itraconazole for progressive, nonmeningeal coccidioidomycosis. A randomized, double-blind trial. Mycoses Study Group.
In previous open-label noncomparative clinical trials, both fluconazole and itraconazole were effective therapy for progressive forms of coccidioidomycosis. ⋯ Neither fluconazole nor itraconazole showed statistically superior efficacy in nonmeningeal coccidioidomycosis, although there is a trend toward slightly greater efficacy with itraconazole at the doses studied.
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The hypoxemia of the hepatopulmonary syndrome, seen in patients with severe chronic liver dysfunction, results from widespread pulmonary vasodilation. No established drug therapy is available for this condition. ⋯ Intravenous methylene blue improved hypoxemia and hyperdynamic circulation in patients with liver cirrhosis and severe hepatopulmonary syndrome.