JAMA : the journal of the American Medical Association
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Diarrheal disease is commonly encountered in clinical practice. Persistent diarrhea (≥14 days) can be caused by pathogens that differ from those commonly seen in acute illness; proper etiologic diagnosis is important for appropriate therapeutic management. This review provides an overview of the epidemiology, etiology, diagnosis, and management of persistent diarrhea caused by infectious agents in immunocompetent individuals worldwide. ⋯ Persistent diarrhea is a poorly recognized syndrome in all populations that requires proper assessment and diagnosis to ensure that affected individuals receive the treatment needed to experience improvement of clinical symptoms.
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Review Practice Guideline Meta Analysis
Screening for Colorectal Cancer: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force.
Colorectal cancer (CRC) remains a significant cause of morbidity and mortality in the United States. ⋯ Colonoscopy, flexible sigmoidoscopy, CTC, and stool tests have differing levels of evidence to support their use, ability to detect cancer and precursor lesions, and risk of serious adverse events in average-risk adults. Although CRC screening has a large body of supporting evidence, additional research is still needed.
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Review Practice Guideline Meta Analysis
Screening for Colorectal Cancer: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force.
Colorectal cancer (CRC) remains a significant cause of morbidity and mortality in the United States. ⋯ Colonoscopy, flexible sigmoidoscopy, CTC, and stool tests have differing levels of evidence to support their use, ability to detect cancer and precursor lesions, and risk of serious adverse events in average-risk adults. Although CRC screening has a large body of supporting evidence, additional research is still needed.
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Review Meta Analysis
Use of Plant-Based Therapies and Menopausal Symptoms: A Systematic Review and Meta-analysis.
Between 40% and 50% of women in Western countries use complementary therapies to manage menopausal symptoms. ⋯ This meta-analysis of clinical trials suggests that composite and specific phytoestrogen supplementations were associated with modest reductions in the frequency of hot flashes and vaginal dryness but no significant reduction in night sweats. However, because of general suboptimal quality and the heterogeneous nature of the current evidence, further rigorous studies are needed to determine the association of plant-based and natural therapies with menopausal health.
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Review Meta Analysis
Association of Pharmacological Treatments for Obesity With Weight Loss and Adverse Events: A Systematic Review and Meta-analysis.
Five medications have been approved for the management of obesity, but data on comparative effectiveness are limited. ⋯ Among overweight or obese adults, orlistat, lorcaserin, naltrexone-bupropion, phentermine-topiramate, and liraglutide, compared with placebo, were each associated with achieving at least 5% weight loss at 52 weeks. Phentermine-topiramate and liraglutide were associated with the highest odds of achieving at least 5% weight loss.