Annals of internal medicine
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Randomized Controlled Trial
Dogma disputed: can aggressively lowering blood pressure in hypertensive patients with coronary artery disease be dangerous?
Because coronary perfusion occurs mainly during diastole, patients with coronary artery disease (CAD) could be at increased risk for coronary events if diastolic pressure falls below critical levels. ⋯ The risk for the primary outcome, all-cause death, and MI, but not stroke, progressively increased with low diastolic blood pressure. Excessive reduction in diastolic pressure should be avoided in patients with CAD who are being treated for hypertension.
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Randomized Controlled Trial Multicenter Study Comparative Study
An evaluation of D-dimer in the diagnosis of pulmonary embolism: a randomized trial.
It may be safe to omit additional diagnostic testing in selected patients with suspected pulmonary embolism (PE) who have a negative D-dimer test, but this approach has never been evaluated in a randomized, controlled trial. ⋯ In patients with a low probability of PE who have negative D-dimer results, additional diagnostic testing can be withheld without increasing the frequency of VTE during follow-up. Low clinical probability and negative D-dimer results occur in 50% of outpatients and in 20% of inpatients with suspected PE.
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Randomized Controlled Trial
Brief communication: ramipril markedly improves walking ability in patients with peripheral arterial disease: a randomized trial.
Peripheral arterial disease (PAD) affects up to 12% of adults older than 50 years of age. Conventional therapies have only modest effects in improving symptoms. ⋯ Ramipril improved pain-free and maximum walking time in some adults with symptomatic PAD.
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Randomized Controlled Trial
Telephone care management to improve cancer screening among low-income women: a randomized, controlled trial.
Minority and low-income women receive fewer cancer screenings than other women. ⋯ Telephone support can improve cancer screening rates among women who visit community and migrant health centers. The intervention seems to be well suited to health plans, large medical groups, and other organizations that seek to increase cancer screening rates and to address disparities in care.
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Randomized Controlled Trial
Adding chloroquine to conventional treatment for glioblastoma multiforme: a randomized, double-blind, placebo-controlled trial.
Malignant cell clones resistant to chemotherapy and radiotherapy frequently lead to treatment failure in patients with glioblastoma multiforme. Preliminary studies suggest that adding chloroquine to conventional therapy may improve treatment outcomes. ⋯ Chloroquine may improve mid-term survival when given in addition to conventional therapy for glioblastoma multiforme. These results suggest that larger, more definitive studies of chloroquine as adjuvant therapy for glioblastoma are warranted.