CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne
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Multicenter Study
The association of cardiovascular disease risk factors with abdominal obesity in Canada. Canadian Heart Health Surveys Research Group.
To assess the degree of association of abdominal obesity with blood pressure and plasma lipid levels and to determine which anthropometric measures of obesity are most closely associated with these cardiovascular risk factors. ⋯ Considerable association was seen between measures of abdominal obesity and blood pressure and plasma lipid levels. WC is the measure of abdominal obesity most highly correlated with these cardiovascular disease risk factors.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Efficacy and safety of finasteride therapy for benign prostatic hyperplasia: results of a 2-year randomized controlled trial (the PROSPECT study). PROscar Safety Plus Efficacy Canadian Two year Study.
To evaluate the efficacy and safety of 2 years' treatment of moderate benign prostatic hyperplasia (BPH) with finasteride. ⋯ Finasteride is a well-tolerated and effective alternative to watchful waiting in the treatment of moderate BPH.
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Multicenter Study Comparative Study
Appropriateness of primary total hip and knee replacements in regions of Ontario with high and low utilization rates.
To compare the appropriateness of case selection for primary hip and knee replacements between two regions in Ontario: one with a high population-based utilization rate and one with a low rate. ⋯ Patients selected for primary hip or knee replacement are similar in the high- and low-rate regions of Ontario. Inappropriate use of this procedure does not account for the high rate of surgery in some areas. Further studies will be required to determine which other factors account for the regional variations in the utilization rates and whether there is underservicing in low-rate areas.
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Multicenter Study
Diagnostic accuracy and short-term surgical outcomes in cases of suspected acute appendicitis.
To test the hypothesis that, with modern diagnostic methods and antibiotics, more conservative use of surgery in cases of suspected appendicitis would not result in increased rates of short-term complications in confirmed cases. ⋯ A higher diagnostic accuracy rate is associated with more perforated appendixes. Although perforation itself leads to adverse outcomes, a higher accuracy rate does not. This suggests that hospitals with higher accuracy rates incur more perforations, but, with close observation, timely laparotomy and the use of modern antibiotics, these patients have favourable outcomes. This contrasts with adverse effects of perforation among patients at high risk for perforation (especially very young children and elderly people) in centres at all accuracy levels. The variation in hospitals' diagnostic accuracy rates suggests that some proportion of appendectomies could be safely avoided.
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Multicenter Study
Impact of chemotherapy-associated nausea and vomiting on patients' functional status and on costs: survey of five Canadian centres.
To estimate the effect of chemotherapy-associated nausea and emesis on patients' functional status and on costs to the health care system, the patients and society before antagonists to the serotonin (5-hydroxytryptamine) receptor subtype 5-HT3 became available. ⋯ Despite prophylaxis with antiemetic drugs, nausea and emesis were significant problems in this population receiving chemotherapy. The management of emesis consumed relatively small amounts of health care resources, but there were costs outside the hospital for patients and others.