The American journal of medicine
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Randomized Controlled Trial
Risk of hypercalcemia in blacks taking hydrochlorothiazide and vitamin D.
Hydrochlorothiazide, an effective antihypertensive medication commonly prescribed to blacks, decreases urinary calcium excretion. Blacks have significantly higher rates of hypertension and lower levels of 25-hydroxyvitamin D. Thus, they are more likely to be exposed to vitamin D supplementation and thiazide diuretics. The risk for hypercalcemia among blacks using vitamin D and hydrochlorothiazide is undefined. ⋯ In summary, vitamin D3 supplementation up to 4000 IU in hydrochlorothiazide users is associated with an increase in serum calcium but a low frequency of hypercalcemia. These findings suggest that participants of this population can use hydrochlorothiazide with up to 4000 IU of vitamin D3 daily and experience a low frequency of hypercalcemia.
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Diagnosis of adrenal-cortisol insufficiency is often misleading in hospitalized patients, as clinical and biochemical features overlap with comorbidities. We analyzed clinical determinants associated with a biochemical diagnosis of adrenal-cortisol insufficiency in non-intensive care unit (ICU) hospitalized patients. ⋯ Commonly reported adrenal-cortisol insufficiency features do not reliably identify hospitalized patients biochemically confirmed to have this disorder. Comorbidities including hepatitis C, prior orthotopic liver transplantation, HIV, and reported pre-existing male hypogonadism may help identify hospitalized non-ICU patients for more rigorous adrenal insufficiency assessment.
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Information is limited about the communication of corrections or errors in the medical literature; therefore, we sought to determine the frequency and significance of published errata in high impact factor journals. ⋯ The reporting of errata across journals lacks uniformity. Despite published criteria for authorship that mandate final approval of the manuscript by all authors, errors are frequent, including those that may materially change the interpretation of data. Increased vigilance by authors to prevent errata and consensus by journal editors on the format of reporting are warranted.
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Caffeine is a commonly consumed substance that has been thought to play a role in the development of tinnitus, but prospective data are lacking. We prospectively evaluated the association between caffeine intake and self-reported tinnitus in a female cohort. ⋯ In this prospective study, higher caffeine intake was associated with a lower risk of incident tinnitus in women.
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The number of hip and knee arthroplasty procedures is steadily increasing as life expectancy increases. Coxiella burnetii may be responsible for culture-negative prosthetic joint arthritis and is associated with antibiotic failure and repeated surgeries. We report the first case series of C. burnetii-related culture-negative prosthetic joint arthritis. ⋯ A systematic, comprehensive diagnostic strategy should be used in culture-negative prosthetic joint arthritis, including testing for C. burnetii in endemic areas.