Arch Intern Med
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Multicenter Study
Depression, falls, and risk of fracture in older women. Study of Osteoporotic Fractures Research Group.
Previous studies have suggested that depression is associated with falls and with low bone density, but it is not known whether depression leads to an increased risk of fracture. ⋯ Depression is a significant risk factor for fracture in older women. The greater frequency of falls among individuals with depression partially explains this finding. Other mechanisms responsible for the association between depression and fracture remain to be determined.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Pilocarpine tablets for the treatment of dry mouth and dry eye symptoms in patients with Sjögren syndrome: a randomized, placebo-controlled, fixed-dose, multicenter trial. P92-01 Study Group.
Patients with Sjögren syndrome (SS) experience slowly progressive infiltration of lacrimal and salivary glands by mononuclear cells. This leads to diminished secretions, with resultant symptoms of xerostomia and xerophthalmia. Although pilocarpine hydrochloride tablets are currently indicated for the treatment of radiation-induced xerostomia, their effects on dry mouth or dry eyes in patients with SS are unclear. ⋯ Administration of 5-mg pilocarpine tablets 4 times daily (20 mg/d) was well tolerated and produced significant improvement in symptoms of dry mouth and dry eyes and other xeroses in patients with SS.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
For COPD a combination of ipratropium bromide and albuterol sulfate is more effective than albuterol base.
A combination metered-dose inhaler aerosol containing ipratropium bromide and albuterol sulfate has been reported to be more effective than either of its components in patients with chronic obstructive pulmonary disease. The dose of albuterol sulfate is equal in moles per liter to the dose of albuterol base used in the commercially available metered-dose inhalers. ⋯ We conclude that a combination of ipratropium bromide and albuterol sulfate is more effective at improving pulmonary function than albuterol base alone, with no potentiation of adverse effects.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Oral vs intravenous ciprofloxacin in the initial empirical management of severe pyelonephritis or complicated urinary tract infections: a prospective randomized clinical trial.
There are few data on the efficacy of oral antibiotics in the initial empirical management of severe forms of urinary tract infection (UTI). ⋯ In the hospital setting, oral ciprofloxacin is as effective as the intravenous regimen in the initial empirical management of serious UTIs, including bacteremic forms, in patients without severe sepsis, obstruction, or renal foci of suppuration. The efficacy of the oral regimen indicates a potential use for ciprofloxacin in outpatient treatment of a subset of patients currently hospitalized on account of disease severity.
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To evaluate the 3 alcohol consumption questions from the Alcohol Use Disorders Identification Test (AUDIT-C) as a brief screening test for heavy drinking and/or active alcohol abuse or dependence. ⋯ Three questions about alcohol consumption (AUDIT-C) appear to be a practical, valid primary care screening test for heavy drinking and/or active alcohol abuse or dependence.