JAMA : the journal of the American Medical Association
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Following 2 years of heated controversy about the resident match, the National Resident Matching Program (NRMP) recently voted to replace the existing matching algorithm with a newly designed applicant-proposing algorithm. ⋯ The existing NRMP algorithm and the newly designed applicant-proposing algorithm perform similarly. Both algorithms make it sensible for applicants and residency programs to arrange their ROLs based solely on their preferences for possible matches. The choice of algorithms will systematically affect the matches of only a small group of applicants (<0.1%). The NRMP's recent decision to use the applicant-proposing algorithm starting in 1998 reflects a judgment about the impact of this difference on applicants and programs.
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To describe the status of palliative care education in the undergraduate medical curriculum and to offer recommendations for improvement. ⋯ The increasing attention to palliative care education has created major opportunities for improving education about care at the end of life. Educational programs should be rigorously evaluated to identify best educational practices.
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Obesity is an important clinical problem, and the use of dexfenfluramine hydrochloride for weight reduction has been widely publicized since its approval by the Food and Drug Administration. However, animal and human studies have demonstrated toxic effects of fenfluramines that clinicians should be aware of when considering prescribing the drugs. Our purpose was to systematically review data on brain serotonin neurotoxicity in animals treated with fenfluramines and the evidence linking fenfluramines to primary pulmonary hypertension (PPH). ⋯ Fenfluramine and dexfenfluramine have been demonstrated to damage brain serotonin neurons in animal studies. It is not known if such damage occurs in humans or if there are clinical consequences. Use of fenfluramines is associated with an increased risk of PPH. Future studies should address the long-term consequences of prolonged use of fenfluramines.