JAMA : the journal of the American Medical Association
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To develop an objective method for assessing organ dysfunction among intensive care unit (ICU) patients on the first day of the ICU stay. ⋯ The LOD System provides an objective tool for assessing severity levels for organ dysfunction in the ICU, a critical component in the conduct of clinical trials. Neurologic, cardiovascular, and renal dysfunction were the most severe organ dysfunctions, followed by pulmonary and hematologic dysfunction, with hepatic dysfunction the least severe. The LOD System takes into account both the relative severity among organ systems and the degree of severity within an organ system.
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Comparative Study
Comparison of IMG-dependent and non-IMG-dependent residencies in the National Resident Matching Program.
To provide insight into the dynamics that determine the pattern of participation of international medical graduates (IMGs) in graduate medical education (GME). ⋯ Persistent differences exist in the mix of USMGs and IMGs applying through the NRMP to IMG-dependent and non-IMG-dependent programs. Over time, programs that enroll large numbers of IMGs are likely to experience an increase in the number and proportion of applications from IMGs and a decrease in the number and proportion of applications from USMGs. If policies are adopted to limit IMG access to GME, IMG-dependent programs may be unable to recruit USMGs unless the total number of GME programs or the quality of existing programs fundamentally changes.
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Multicenter Study
Results of radical prostatectomy in men with clinically localized prostate cancer.
To assess the results of radical prostatectomy in men with early prostate cancer. ⋯ Radical prostatectomy leads to high 10-year disease-specific survival rates in men with all tumor grades. However, caution is needed in comparing these results with similar studies of alternative treatment strategies, such as watchful waiting, due to the inherent potential biases in uncontrolled trials. Nevertheless, these results offer the best currently available estimates of 10-year outcome of radical prostatectomy in men with clinically localized prostate cancer and may be useful in counseling patients with early malignancy.