Arch Intern Med
-
Medical errors occur and are sometimes unavoidable. Physicians generally, but not always, have ethical and moral obligations to disclose their errors to the patient. ⋯ However, the obligations of physicians to disclose errors made by others are less clear. This article discusses the professional ethics involved in disclosing and preventing medical errors.
-
Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Efficacy and safety of sibutramine in obese white and African American patients with hypertension: a 1-year, double-blind, placebo-controlled, multicenter trial.
Obesity is a highly prevalent medical condition and is commonly accompanied by hypertension. This study assessed the efficacy and safety of treatment with sibutramine hydrochloride for promoting and maintaining weight loss in obese patients with controlled hypertension, including a subset analysis of African American patients. ⋯ In obese patients with controlled hypertension, sibutramine was an effective and well-tolerated treatment for weight loss and maintenance. Sibutramine-induced weight loss resulted in improvements in serum levels of triglycerides, HDL-C, uric acid, and glucose, and in waist circumference and quality-of-life measures. Blood pressure and heart rate increased by a small amount. Efficacy and safety profiles for sibutramine among African American and white obese patients with controlled hypertension were similar.
-
Comparative Study
Continuously increasing number and incidence of fall-induced, fracture-associated, spinal cord injuries in elderly persons.
Although osteoporosis, falls, and fractures among older adults are said to be a continuously increasing public health problem, reliable epidemiological information on their secular trends is very limited. ⋯ In Finnish persons aged 50 years or older, the number of fall-induced, fracture-associated, spinal cord injuries shows a rise with a rate that cannot be explained merely by demographic changes. The finding shows an increasing influence of osteoporosis and falls on health and well-being of our older adults, and therefore, vigorous preventive measures are needed to control this development.
-
Comparative Study
Identifying patients for weight-loss treatment: an empirical evaluation of the NHLBI obesity education initiative expert panel treatment recommendations.
The NHLBI (National Heart, Lung, and Blood Institute) Obesity Education Initiative Expert Panel recently proposed that clinicians and other health care professionals use a new treatment algorithm to identify patients for weight-loss treatment. In addition to the usual assessment of body mass index (BMI, calculated as weight in kilograms divided by the square of height in meters), the new algorithm includes the assessment of abdominal obesity (as measured by waist circumference) and other cardiovascular disease (CVD) risk factors. ⋯ Despite the potential importance of abdominal obesity as a CVD risk factor, these results challenge the clinical utility of including waist circumference in this new algorithm and suggest that using BMI and CVD risk factors may be sufficient.
-
Comparative Study
Associations of general and abdominal obesity with multiple health outcomes in older women: the Iowa Women's Health Study.
Recent clinical guidelines on the health risks of obesity use body mass index (BMI; calculated as weight in kilograms divided by the square of height in meters) and waist circumference, but the waist-hip ratio may provide independent information. ⋯ The waist-hip ratio offers additional prognostic information beyond BMI and waist circumference.