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The authors randomly assigned patients to self-management of anticoagulation or to conventional clinic management. Self-managed patients had equally good control of anticoagulation and fewer adverse events. Major complications and minor hemorrhages were less common in the self-management group.
In this sample of male health professionals, light and moderate use of alcohol was not associated with an increased risk for ischemic stroke. Moderate intake of red wine, but not other beverages, was associated with a reduced risk for stroke. Intake of more than 2 drinks per day may be associated with a higher risk for ischemic stroke.
The risk factors for acute pyleonephritis in nonpregnant, community-dwelling reproductive-age women are similar to the risk factors for acute cystitis. Sexual behaviors, personal and family history of urinary tract infection, diabetes, and incontinence are associated with increased risk.
This Update incorporates an overview of articles on stroke, transient ischemic attack, and cerebrovascular disease; hypertension; multiple sclerosis; inflammation; infectious diseases; neurocardiogenic syncope; dementia; seizures; language and autism; myelopathies; Hashimoto encephalopathy; intracranial hypotension or headache; back and neck pain; restless legs syndrome; and drugs and toxins.
This meta-analysis of 19 randomized, controlled trials involving more than 135 000 participants found that high-dosage vitamin E supplementation (≥400 IU/d for at least 1 year) increased all-cause mortality. The effects of lower-dosage supplementation were unclear.
Many diseases can mimic infectious cellulitis. The authors review several vascular, dermatologic, rheumatic, immunologic–idiopathic, malignant, and familial diseases that physicians should consider in a patient with signs of infectious cellulitis.
This review describes the characteristics, costs, and effectiveness of major weight loss programs that provide in-person or Internet-based counseling.
Residents of the United States who travel abroad to visit friends and relatives become exposed to greater risks for infection than most tourists. The authors describe this population, discuss travel-related health disparities, and provide recommendations for improving preventive care before travel.
Menéndez-Jándula and colleagues' study in this issue provides further evidence that patient self-management of anticoagulation leads to better reliability, better quality, and reduced risks and is therefore a valuable model of care for the long-term management of anticoagulation.
In this issue, Miller and colleagues provide good evidence that people should avoid high-dosage vitamin E supplementation. Taking high-dosage vitamin E in later adult life has no favorable health effects, and this meta-analysis raises the possibility of harm. Our message to the public must be clear on this point: Vitamin E supplements won't help and might harm, so save your money.
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