Journal of general internal medicine
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Randomized Controlled Trial
Factors associated with the hospitalization of low-risk patients with community-acquired pneumonia in a cluster-randomized trial.
Many low-risk patients with pneumonia are hospitalized despite recommendations to treat such patients in the outpatient setting. ⋯ Hospital admission appears justified for one-third of low-risk inpatients based upon the presence of one or more contraindications to outpatient treatment. At least one-fifth of low-risk inpatients did not have a contraindication to outpatient treatment or an identifiable risk factor for hospitalization, suggesting that treatment of a larger proportion of such low-risk patients in the outpatient setting could be achieved without adversely affecting patient outcomes.
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The prevalence of torture among foreign-born patients presenting to urban medical clinics is not well documented. ⋯ Among foreign-born patients presenting to an urban primary care center, approximately 1 in 9 met the definition established by the UN Convention Against Torture. As survivors of torture may have significant psychological and physical sequelae, these data underscore the necessity for primary care physicians to screen for a torture history among foreign-born patients.
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To evaluate the evidence of the supplements vitamin C and vitamin E for treatment and prevention of cancer. ⋯ The systematic review of the literature does not support the hypothesis that the use of supplements of vitamin C or vitamin E in the doses tested helps prevent and/or treat cancer in the populations tested. There were isolated findings of benefit, which require confirmation.
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The Accreditation Council for Graduate Medical Education duty hour requirements may affect residents' understanding and practice of professionalism. ⋯ Residents perceive challenges to incorporating professionalism into their daily practice. The duty hour implementation offers new challenges and opportunities for negotiating the principles of professionalism.
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Homelessness is associated with high rates of health and substance use problems. ⋯ The homeless population is aging by about two thirds of a year every calendar year, consistent with trends in several other cities. It is likely that the homeless are static, aging population cohort. The aging trends suggest that chronic conditions will become increasingly prominent for homeless health services. This will present challenges to traditional approaches to screening, prevention, and treatment of chronic diseases in an aging homeless population.