JAMA : the journal of the American Medical Association
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Randomized Controlled Trial Multicenter Study Clinical Trial
Effect of estrogen therapy on gallbladder disease.
Estrogen therapy is thought to promote gallstone formation and cholecystitis but most data derive from observational studies rather than randomized trials. ⋯ These data suggest an increase in risk of biliary tract disease among postmenopausal women using estrogen therapy. The morbidity and cost associated with these outcomes may need to be considered in decisions regarding the use of estrogen therapy.
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Folate has important beneficial effects on endothelial function, but there is limited information about folate intake and risk of incident hypertension. ⋯ Higher total folate intake was associated with a decreased risk of incident hypertension, particularly in younger women.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Effectiveness of a quality improvement intervention for adolescent depression in primary care clinics: a randomized controlled trial.
Depression is a common condition associated with significant morbidity in adolescents. Few depressed adolescents receive effective treatment for depression in primary care settings. ⋯ A 6-month quality improvement intervention aimed at improving access to evidence-based depression treatments through primary care was significantly more effective than usual care for depressed adolescents from diverse primary care practices. The greater uptake of counseling vs medication under the intervention reinforces the importance of practice interventions that include resources to enable evidence-based psychotherapy for depressed adolescents.