Arch Intern Med
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Review Meta Analysis
Risk of fatal and nonfatal lactic acidosis with metformin use in type 2 diabetes mellitus: systematic review and meta-analysis.
Metformin therapy for type 2 diabetes mellitus has been shown to reduce total mortality rates compared with other antihyperglycemic treatments but is thought to increase the risk of lactic acidosis. The true incidence of fatal and nonfatal lactic acidosis associated with metformin use is not known. ⋯ There is no evidence to date that metformin therapy is associated with an increased risk of lactic acidosis or with increased levels of lactate compared with other antihyperglycemic treatments if the drugs are prescribed under study conditions, taking into account contraindications.
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Although computerized physician order entry reduces medication errors among inpatients, little is known about the use of this system in primary care. ⋯ Few physicians changed their prescription in response to a drug allergy or interaction alert, and there were few ADEs, suggesting that the threshold for alerting was set too low. Computerized physician order entry systems should suppress alerts for renewals of medication combinations that patients currently tolerate.
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Comparative Study
Body mass index in middle age and health-related quality of life in older age: the Chicago heart association detection project in industry study.
Overweight and obesity are associated with higher morbidity and shorter life expectancy, but the effect of body mass index (BMI) (calculated as weight in kilograms divided by the square of height in meters) ascertained during middle age on subsequent quality of life among older survivors is unknown. This study evaluates whether BMI in middle age is related to health-related quality of life in older age. ⋯ A higher BMI in middle age is associated with a poorer quality of life in older age. Preventive measures may lessen the burden of disease and impaired quality of life associated with excess weight.
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Homeless persons experience high rates of sexual and physical assault; homeless women are thought to be at highest risk. To determine the prevalence, distribution, and factors associated with sexual and physical assault, we surveyed homeless and marginally housed adults in San Francisco, Calif. ⋯ Sexual and physical assault are common experiences for homeless and marginally housed persons. Housing is associated with lower rates of sexual assault among women. Strategies to decrease sexual and physical assault and its consequences are needed in this population.