The American journal of medicine
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There are limited data regarding the relationship between cannabinoids and metabolic processes. Epidemiologic studies have found lower prevalence rates of obesity and diabetes mellitus in marijuana users compared with people who have never used marijuana, suggesting a relationship between cannabinoids and peripheral metabolic processes. To date, no study has investigated the relationship between marijuana use and fasting insulin, glucose, and insulin resistance. ⋯ We found that marijuana use was associated with lower levels of fasting insulin and HOMA-IR, and smaller waist circumference.
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Over the last 15 years, substantial advances have been made in the treatment of chronic obstructive pulmonary disease (COPD). Little information is available, however, on whether these treatments have resulted in reduced rates of hospitalization and acute exacerbations among COPD patients. This retrospective cohort study examined changes in hospitalization rates among Medicare beneficiaries with COPD from 1999 to 2008. ⋯ Between 1999 and 2008, hospitalization rates decreased substantially among Medicare beneficiaries diagnosed with COPD.
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Comparative Study
Functional disability, cognitive impairment, and depression after hospitalization for pneumonia.
The study objective was to examine whether hospitalization for pneumonia is associated with functional decline, cognitive impairment, and depression, and to compare this impairment with that seen after known disabling conditions, such as myocardial infarction or stroke. ⋯ Hospitalization for pneumonia in older adults is associated with subsequent functional and cognitive impairment. Improved pneumonia prevention and interventions to ameliorate adverse sequelae during and after hospitalization may improve outcomes.
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The study objective was to examine the association between pre-hospital serum vitamin D concentration and mortality after hospitalization. ⋯ Analysis of 23,603 hospitalized patients identified both 25(OH)D ≤15 ng/mL and 25(OH)D 15 to 30 ng/mL before hospital admission as associated with the odds of all-cause patient mortality at 30 days after hospitalization. In addition, pre-hospital serum 25(OH)D ≤15 ng/mL is significantly associated with the odds of community-acquired bloodstream infection.
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Patients with atrial fibrillation often have cardiovascular risk factors or known comorbid disease, yet the use of evidence-based primary and secondary prevention cardiac therapy among atrial fibrillation outpatients is unknown. ⋯ The majority of eligible atrial fibrillation outpatients did not receive all guideline-recommended therapies for cardiovascular comorbid conditions and risk factors. This represents a potential opportunity to improve atrial fibrillation patients' quality of care and outcomes.