JAMA : the journal of the American Medical Association
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Comparative Study
The relative effects of left ventricular hypertrophy, coronary artery disease, and ventricular dysfunction on survival among black adults.
To evaluate the effect of echocardiographically determined left ventricular hypertrophy (LVH) on survival in comparison with number of stenosed vessels and left ventricular systolic dysfunction. ⋯ Left ventricular hypertrophy was associated with a greater RR and attributable risk than the traditional measures of coronary disease severity. The high prevalence and powerful risk of LVH make an important contribution to the adverse survival rates among black patients with heart disease and may account for much of the black-white differential.
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To evaluate diabetes mellitus as a risk factor for pancreatic cancer with the consideration that diabetes may also be a consequence of pancreatic cancer. ⋯ Pancreatic cancer occurs with increased frequency among persons with long-standing diabetes.
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Because of the size and growth of the international medical graduate (IMG) contribution to graduate medical education (GME) in the United States, and subsequently to the US physician workforce, it is essential to understand the demographics and patterns of IMG training and practice as well as the routes of entry into the United States. ⋯ In recent years, participation of IMGs in GME and practice has increased significantly. Most IMGs in GME are not exchange visitors, but are either permanent residents or US citizens. Patterns of specialization and location of IMGs ultimately mirror those of USMGs. National IMG policy must be examined in light of the projected surplus of physicians in the United States. The best option for long-term control of the number of physicians in practice, USMG or IMG, is a system of specifying the number of GME positions nationally.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Transfusion requirements in critical care. A pilot study. Canadian Critical Care Trials Group.
To evaluate the effects of a restrictive and a liberal red blood cell (RBC) transfusion strategy on mortality and morbidity in critically ill patients. ⋯ In this small randomized trial, neither mortality nor the development of organ dysfunction was affected by the transfusion strategy, which suggests that a more restrictive approach to the transfusion of RBCs may be safe in critically ill patients. However, the study lacked power to detect small but clinically significant differences. Therefore, further investigations of RBC transfusion strategies are warranted.