Arch Intern Med
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Statin cholesterol-lowering drugs are among the most prescribed drugs in the United States. Their cardiac benefits are substantial and well supported. However, there has been persistent controversy regarding possible favorable or adverse effects of statins or of cholesterol reduction on cognition, mood, and behavior (including aggressive or violent behavior). ⋯ There is a strong need for randomized controlled trial data to more clearly establish the impact of hydrophilic and lipophilic statins on cognition, aggression, and serotonin, as well as on other measures relevant to risks and quality-of-life impact in noncardiac domains.
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The use of Web-based technology and a collaborative model to improve hospital adherence to secondary prevention guidelines has not been previously evaluated. ⋯ Implementation of a collaborative quality improvement initiative, interactive training of hospital teams with physician champions, and the use of an interactive Web-based Patient Management Tool enhanced adherence to prevention guidelines in hospitalized patients with coronary artery disease.
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Restless legs syndrome (RLS) is characterized by the desire to move the limbs associated with paresthesias of the legs, a motor restlessness, an intensification of symptoms at rest with relief by activity, and a worsening of symptoms in the evening or at night. Population-based studies are rare, and risk factors in the general population are not known. ⋯ Restless legs syndrome is a common disease in the general population, affecting women more often than men. It is associated with reduced quality of life in cross-sectional analysis. Parity is a major factor in explaining the sex difference and may guide further clarification of the etiology of the disease.
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Pain and satisfaction with pain control in hospitalized medical patients: no such thing as low risk.
Pain is common in many populations of hospitalized patients. It is unknown if any populations of hospitalized patients are at low risk for pain. We studied the prevalence of pain and satisfaction with pain control in a general medicine inpatient service to determine if this population was at low risk for pain. ⋯ Pain was common in the study population and more patients rated their pain as severe than as moderate or mild. Pain was dispersed among diagnoses. Although most patients thought that their pain was adequately controlled, 18% of patients with pain (10% of all patients) reported that their pain was inadequately controlled. Although patient characteristics were associated with pain or dissatisfaction with pain control, they were weak predictors and significant pain was common even in populations at the lowest-risk for pain.
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Randomized Controlled Trial Clinical Trial
Prospective investigation of adverse effects of acupuncture in 97 733 patients.