Annals of internal medicine
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Helical computed tomography (CT) is a readily available tool for diagnosing pulmonary embolism (PE); however, its role in the management of patients with clinically suspected PE has not been fully established. ⋯ In patients with suspected PE, helical CT can be used safely as the primary diagnostic test to rule out PE. Serial compression ultrasonography has limited additional value.
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The health implications of regional differences in Medicare spending are unknown. ⋯ Regional differences in Medicare spending are largely explained by the more inpatient-based and specialist-oriented pattern of practice observed in high-spending regions. Neither quality of care nor access to care appear to be better for Medicare enrollees in higher-spending regions.
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The health implications of regional differences in Medicare spending are unknown. ⋯ Medicare enrollees in higher-spending regions receive more care than those in lower-spending regions but do not have better health outcomes or satisfaction with care. Efforts to reduce spending should proceed with caution, but policies to better manage further spending growth are warranted.
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Increased use of complementary and alternative medicine (CAM) has made it imperative that these topics be included in medical education from the preclinical years through residency and beyond. There has been progress in this direction in recent years, with a steady increase in the number of medical schools that include CAM therapies in their curricula. ⋯ This article examines the questions that arise when medical educators consider how to incorporate CAM therapies as an integral part of the medical curriculum. It offers practical suggestions for finding time in an already packed curriculum, getting started, including faculty and students in the process, and sustaining the initiative with the necessary administrative and institutional support.