Arch Intern Med
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Testing stool for occult blood at the time of digital rectal examination (DRE) has been discouraged because it is thought to increase the number of false-positive test results. ⋯ Testing stool for occult blood at the time of DRE does not increase the number of false-positive test results or the cost per cancer detected in asymptomatic patients at average risk for colorectal cancer. In this patient population, all individuals should be evaluated by full colonoscopy regardless of the method of stool collection.
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Randomized Controlled Trial Clinical Trial
Randomized double-blind study comparing the efficacy of gabapentin with amitriptyline on diabetic peripheral neuropathy pain.
Reports of gabapentin use in diabetic peripheral neuropathy pain stimulate a need for controlled trials to determine its comparative efficacy to the therapeutic standard of amitriptyline hydrochloride. ⋯ Although both drugs provide pain relief, mean pain score and global pain score data indicate no significant difference between gabapentin and amitriptyline. Gabapentin may be an alternative for treating diabetic peripheral neuropathy pain, yet does not appear to offer considerable advantage over amitriptyline and is more expensive. Larger trials are necessary to define gabapentin's place in treating diabetic peripheral neuropathy pain.
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Randomized Controlled Trial Clinical Trial
Effects of high-dose inhaled corticosteroids on plasma cortisol concentrations in healthy adults.
Recent studies suggest that inhaled corticosteroids may differ significantly in their systemic effects. ⋯ These results indicate that there are differences in the systemic effects of inhaled corticosteroids when used in high doses and emphasize the importance of using the minimum dose of inhaled corticosteroids required to maintain control of asthma symptoms.
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To determine the risk of cardiovascular events and death in patients receiving statin treatment for cholesterol regulation. ⋯ Patients who received statin treatment demonstrated a 20% to 30% reduction in death and major cardiovascular events compared with patients who received placebo. This advantage was generally present across study types and statin treatment types and for patients with less severe dyslipidemias. The benefit in clinical outcomes was noticeable as early as 1 year.
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An outbreak of Escherichia coli O157:H7 infections in Connecticut and Illinois during May 28 to June 27, 1996, was investigated to determine the source of infections. ⋯ This multistate outbreak of E. coli O157:H7 infections was associated with consumption of mesclun lettuce from a single producer. Molecular subtyping facilitated the epidemiological investigation. This investigation increased the knowledge about current production practices that may contribute to the contamination of lettuce by microbial pathogens. Lettuce production practices should be monitored for microbiological safety.