J Concato

..Accordingly, we evaluated the sensitivity of prostate-specific antigen (PSA) velocity among men who are diagnosed subsequently with prostate cancer...

..As of 2008, the need to counsel patients regarding the possible benefits and harms that can result from screening for (and treating) prostate cancer remains justified...

..Potential sources of bias are discussed, as well as corresponding strategies used to avoid them. Results are expected in the year 2002...

....

..We used published meta-analyses to identify randomized clinical trials and observational studies that examined the same clinical topics. We then compared the results of the original reports according to the type of research design...

..Unless a more balanced strategy evolves, new claims of methodological authority may be just as problematic as the traditional claims of medical authority that have been criticized by proponents of evidence-based medicine...

..Evidence is lacking, however, to confirm a survival benefit among screened patients. We evaluated the effectiveness of PSA, with or without DRE, in reducing mortality...

..A review of these (and other) selected projects, based on their type of study design, serves to highlight the strengths, limitations, and potential of CER...

..This study was designed to examine relationships of deployment to the Gulf, as well as symptoms after military service, with postdeployment activity of acetylcholinesterase (AChE) and related enzymes...

..The results suggest that increasing use of beta-blockers in this group provides an opportunity to improve outcomes...

..Clinicians should consider factors such as these when targeting caregivers for interventions to alleviate burden...

....

..To demonstrate the importance of accurately identifying clinical distinctions of subjects in observational studies of screening...

..The under-diagnosis of diabetes in the general population, combined with the association of diabetes and stroke, suggests a rationale for screening for diabetes among hyperglycaemic stroke patients...

..To elicit treatment preferences of patients with rheumatoid arthritis (RA) for disease modifying antirheumatic drugs (DMARDs) with varying risk profiles...

..To determine whether stage of disease and treatment patterns account for mortality differences between black and white women with cervical cancer...

..This project describes the range of observed values of the HOMA and FPI in a large sample of the U.S. population...

..13 (95% confidence interval, 1.23-3.70) and a P value of .007. CONCLUSION: Good preoperative glycemic control (HbA(1c) levels <7%) is associated with a decrease in infectious complications across a variety of surgical procedures...

..Prior research has indicated an association between insulin resistance and stroke; we sought to determine if this association persists after adjusting for stroke risk factors, including glycemic control...

..Although many studies have documented problems in communication between physicians and patients, few have focused on discussions regarding prognosis among community dwelling patients with terminal illness...

..To examine the influence of age and comorbidity on intensification of medical therapy for patients with poorly controlled diabetes mellitus (DM)...

....

..Our objective was to determine if differences in income, education, and insurance, as well as differences in the prevalence of stroke risk factors, accounted for the association between ethnicity and stroke...

....

..The impact of BCR on subsequent mortality is uncertain, however, especially given competing causes of death...

..70, and an FEV(1) below the 5th or 10th standardized residual percentile ("SR-tile strategy")...

..Our objective was to determine the proportion of men with castrate-resistant prostate cancer (CRPC) in a clinical setting that would have been excluded from major phase 3 RCTs...

..The clinical validity of this threshold as a basis for establishing chronic obstructive pulmonary disease is unknown...

..To develop a more age-appropriate spirometric definition of chronic obstructive pulmonary disease (COPD) among older persons...

..To determine whether peak expiratory flow (PEF), when expressed by a validated method using standardized residual (SR) percentile, is associated with subsequent disability and death in older persons...

..Older adults are commonly prescribed sedative-hypnotic (SH) medications when hospitalized, yet these drugs are associated with important adverse effects such as falls and delirium...

..Gender differences exist regarding alcohol and illicit drug use disorders in the United States. Little is known about the gender-related factors associated with non-medical use of prescription opioids...

....

....

..The results of studies about dietary fish consumption and stroke risk have been conflicting. We sought to examine the relationship between dietary fish and seafood consumption and the risk of stroke or transient ischemic attack (TIA)...

..We sought to determine the rates of hospital readmissions and mortality and the reasons for readmission over a 5-year period after stroke...

..To determine the relationship between hydroxymethyl glutaryl coenzyme A reductase inhibitor (statin) use and proximal muscle strength, cognition, and depression in older adults...

..Our objectives were to determine how frequently informed consent is obtained when tPA is given to stroke patients in clinical practice and whether the person providing consent (patient or surrogate) was the appropriate decision-maker...

....

..quot; We investigated whether some patients with rheumatoid arthritis (RA) treat the risk of adverse effects (AE) as "protected values," i.e., as unacceptable regardless of how small the risk...

..We sought to identify factors associated with disability due to pain in a sample of older veterans receiving primary care...

..The objectives of this study were to identify predictors of 6-month mortality and to evaluate 5-year mortality in patients with cerebrovascular disease...

....

..Scant data are available, however, regarding the utility of CRS in clinical practice...

..Prospective studies are needed to better define the health-related effects of alcohol use in older populations...

..07; 95% CI 0.01, 0.4). CONCLUSION: Using data from the EMR, we could assess adherence to the guidelines for antibiotic use and identify areas to target for improving diagnostic testing and reducing overuse of antibiotics in our clinic...

..To assess resilience of community-dwelling older persons using a new scale based on response to a stressful life event and to identify the demographic, clinical, functional, and psychosocial factors associated with high resilience...

..e., by a perception that COX-2 inhibitors eliminate the risk of serious gastrointestinal (GI) events in contrast to merely reduce their risk...

..To examine whether the current widespread use of antiinflammatory drugs may reflect a lack of informed choice (i.e., unawareness of adverse effects or potential treatment alternatives) among older patients with knee osteoarthritis (OA)...

..A genetic basis has been identified for many medical conditions and some molecular tests have been commercialized. However, little attention has been given to the quality of clinical epidemiology in molecular studies...

..Until optimal methods for measuring alcohol exposures in elderly adults are defined, we suggest that a combination of measures be used when obtaining alcohol histories in older persons...

....

..This study aims to determine whether obstructive sleep apnea independently increases the risk of coronary events, including death from cardiovascular causes...

....

..Evidence is accumulating to suggest that clinical guidelines should be modified for patients with comorbidities, yet there is no quantitative and objective approach that considers benefits together with risks...

..005). CONCLUSIONS: The obstructive sleep apnea syndrome significantly increases the risk of stroke or death from any cause, and the increase is independent of other risk factors, including hypertension...

..We suggest development of an empirically-derived index of comorbid conditions and weights may be warranted for older general medical patients...

..To examine the effect of race and birth weight independent of other sociodemographic factors on injury related infant death using national data...

..Current methods to assess the prognosis of prostate cancer at the time of diagnosis are limited...

..Our objective was to assess whether variability in treatment protocols of RCTs investigating the same topic could explain distinct patterns of outcomes...

..An upward shift has occurred in the distribution of Gleason scores during the past decade; this change was influenced by reports suggesting that lower scores (range, 2-4) should not be assigned to biopsy specimens...

..It has not been determined, however, whether sleep apnea is independently associated with the subsequent development of diabetes, accounting for established risk factors...

..Most clinical studies are done to show comparative superiority, but many reports now claim equivalence between the investigated entities. These assertions may not always be supported by the methods used and the results obtained...

..The goal of this study was to compare renal outcomes in patients treated with PTRAS with those managed conservatively...

..Educational experiences in ambulatory medicine vary by site. Purpose: To evaluate variations in patient mix and challenges in patient care at 3 ambulatory training sites...

..The challenge remaining for rheumatologists is how to effectively communicate the risks and benefits related to the many options that are currently available for RA patients...

..Our results suggest that certain patients, especially those with milder disease activity, might be reluctant to accept commonly used arthritis medications if they are fully informed of their potential toxicity...

..To examine the amount of improvement in renal survival that lupus patients require before choosing cyclophosphamide over azathioprine for the treatment of lupus nephritis...

..The objective of this study was to measure VEGF expression in PrCa specimens, using IHC analysis with antibodies from different manufacturers and different antigen retrieval techniques...

..g. markers of cell-cycle regulation), in addition to the effect of traditional clinical factors (e.g. anatomical stage, histological grade), in predicting long-term mortality among men newly diagnosed with prostate cancer...

..Such efforts are essential for the improvement of guidelines and to inform health policy optimally...

..CONCLUSIONS: Primary care physicians may "underdetect" AUDs among older patients. The development of age-specific screening methods and physician education may facilitate detection of older patients with (or at risk for) these disorders...

..This suggests that insulin resistance is mediated at the level of individual organs and that different mechanisms are involved in muscle and vascular tissue...

..Others argue that delays will persist until routine screening is adopted. The Veterans Health Administration (VA) is a unique laboratory to examine whether access to comprehensive health benefits results in earlier entry into HIV care...

..These findings are consistent with the hypothesis that light to moderate drinking confers cognitive benefits to older persons...

..We conducted a critical review of the many studies that have tried to determine whether breastfeeding has a beneficial effect on intellect...

..To identify the specific bathing subtasks that are affected in community-living-older persons with bathing disability and to determine the self-reported reasons for bathing disability...

..To determine whether the presence of depressive symptoms is an independent risk factor for disabling back pain in community-dwelling older persons...

....

..Further research is needed to identify the reasons for the racial disparity in PSA surveillance and to design interventions to lessen these differences...

..S. ratio. These results indicate that contrary to prevailing beliefs, alcohol, illicit drug, and tobacco users are uncommon on prime-time TV and are less prevalent than in the U.S. population...

..82 to 1.04. Areas under the receiver operating characteristic curve were similar (range = 0.50-0.58) across tests. In conclusion, MCV, AST, ALT, and the AST/ALT ratio are not useful markers of alcohol disorders in older male veterans...

..To investigate gender preferences for obstetricians in a hospital setting and to examine its relationship to patient satisfaction...