Arch Intern Med
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Multicenter Study Comparative Study
Serum urea nitrogen, creatinine, and estimators of renal function: mortality in older patients with cardiovascular disease.
Renal dysfunction predicts increased mortality in cardiovascular patients, but the best renal estimator for quantifying risks is uncertain. We compared admission serum urea nitrogen (SUN) level, creatinine level, Modification of Diet in Renal Disease (MDRD) rate, and Mayo estimated glomerular filtration rate (eGFR) for predicting mortality. ⋯ In older cardiovascular patients, SUN- and creatinine-based measures were powerful predictors of postdischarge mortality. Only MDRD eGFR was less adequate in quantifying risks for patients with mild impairment. Novel estimators, such as the Mayo eGFR, may play an important role in outcomes' prognostication for these patients.
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Randomized Controlled Trial
Cost-effectiveness of B-type natriuretic peptide testing in patients with acute dyspnea.
B-type natriuretic peptide (BNP) is a quantitative marker of heart failure that seems to be helpful in its diagnosis. ⋯ Testing of BNP is cost-effective in patients with acute dyspnea.
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Randomized Controlled Trial
Lowering the threshold for discussions of domestic violence: a randomized controlled trial of computer screening.
Women experiencing domestic violence (DV) frequent health care settings, but DV is rarely identified. ⋯ Computer screening for DV increased but did not guarantee that DV would be addressed during ED encounters. Nonetheless, it is likely that low-cost interventions that allow patients the opportunity to self-disclose can be used to improve detection of DV.
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Comment Letter Comparative Study
Breast cancer prevention: time for randomized controlled trials with statins.