Annals of internal medicine
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High plasma homocysteine level has been associated with increased risk for coronary heart disease (CHD) events in nondiabetic individuals, especially in those with previously diagnosed CHD. In persons with type 2 diabetes mellitus, the association between homocysteine level and cardiovascular disease may be stronger than that in nondiabetic individuals, but no large prospective studies have examined the relationship between homocysteine level and CHD mortality in persons with type 2 diabetes. ⋯ In this large cohort of patients with type 2 diabetes, plasma homocysteine level was a strong and independent risk factor for CHD events.
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Review Meta Analysis
The accuracy of the Ottawa knee rule to rule out knee fractures: a systematic review.
The Ottawa knee rule is a clinical decision aid that helps rule out fractures and avoid unnecessary radiography. ⋯ A negative result on an Ottawa knee rule test accurately excluded knee fractures after acute knee injury. However, because the rule is calibrated toward 100% sensitivity and actual fracture prevalences are usually low, large-scale, multicentered studies are still needed to establish the cost-effectiveness of routinely implementing the rule.
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Randomized Controlled Trial Clinical Trial
Graded activity for low back pain in occupational health care: a randomized, controlled trial.
Low back pain is a common medical and social problem frequently associated with disability and absence from work. However, data on effective return to work after interventions for low back pain are scarce. ⋯ Graded activity was more effective than usual care in reducing the number of days of absence from work because of low back pain.