The American journal of medicine
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Randomized Controlled Trial Multicenter Study Clinical Trial
Improving completion of advance directives in the primary care setting: a randomized controlled trial.
Since 1991, hospitals have asked patients whether they have advance directives, but few patients complete these documents. We assessed two simple interventions to improve completion of advance directives among elderly or chronically ill outpatients. ⋯ Mailing health care proxy and living will forms and literature to patients before an appointment at which their physicians received a reminder about advance directives yielded a small but significant improvement in completion of these documents. A physician reminder alone did not have an effect.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Differences in treatment outcome for hepatitis C among ethnic groups.
Studies of interferon-based therapies for hepatitis C virus (HCV)-infected patients have documented variable response rates according to ethnicity. However, these studies enrolled low numbers of ethnic minorities. ⋯ Sustained response rates to interferon and ribavirin therapy differ among ethnic groups. Ethnicity appears to be associated with treatment outcomes, even in a model that adjusts for other factors that influence response to therapy.
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Randomized Controlled Trial Clinical Trial
Effects of ACE gene insertion/deletion polymorphism on response to spironolactone in patients with chronic heart failure.
Angiotensin-converting enzyme (ACE) is involved in the pathophysiology of chronic heart failure, and its activity is determined in part by a polymorphism of the ACE gene. We hypothesized that the benefits of spironolactone, which inhibits downstream elements of ACE-mediated abnormalities, may depend on ACE genotype. ⋯ The effects of spironolactone treatment on left ventricular systolic function and remodeling may in part depend on ACE genotype.
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Randomized Controlled Trial Comparative Study Clinical Trial
Effects of carvedilol on oxidative stress in polymorphonuclear and mononuclear cells in patients with essential hypertension.
To compare the effects of carvedilol and propranolol on oxidative stress in leukocytes and C-reactive protein levels in patients with hypertension. ⋯ These findings suggest that carvedilol inhibits oxidative stress in polymorphonuclear and mononuclear cells, as well as lowers C-reactive protein levels, to a greater extent than does propranolol in hypertensive patients.
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Randomized Controlled Trial Multicenter Study Clinical Trial
A controlled trial of including symptom data in computer-based care suggestions for managing patients with chronic heart failure.
Heart failure is common and associated with considerable morbidity and cost, yet physician adherence to treatment guidelines is suboptimal. We conducted a randomized controlled study to determine if adding symptom information to evidence-based, computer-generated care suggestions would affect treatment decisions among primary care physicians caring for outpatients with heart failure at two Veterans Affairs medical centers. ⋯ Adding symptom information to computer-generated care suggestions for patients with heart failure did not affect physician treatment decisions or improve patient outcomes.