Annals of internal medicine
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Acute exacerbation of chronic obstructive pulmonary disease (COPD) is 1 of the 10 leading causes of hospitalization among adults in the United States. ⋯ The quality of care for patients hospitalized for acute exacerbations of COPD may be improved by increasing the use of systemic corticosteroid and antibiotic therapy, decreasing the use of unnecessary and potentially harmful treatments, and reducing variation in practice across hospitals.
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Randomized Controlled Trial Multicenter Study Comparative Study
An evaluation of D-dimer in the diagnosis of pulmonary embolism: a randomized trial.
It may be safe to omit additional diagnostic testing in selected patients with suspected pulmonary embolism (PE) who have a negative D-dimer test, but this approach has never been evaluated in a randomized, controlled trial. ⋯ In patients with a low probability of PE who have negative D-dimer results, additional diagnostic testing can be withheld without increasing the frequency of VTE during follow-up. Low clinical probability and negative D-dimer results occur in 50% of outpatients and in 20% of inpatients with suspected PE.
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Naps during extended work shifts are effective in reducing fatigue in other industries, but the use of a nap as a countermeasure to prevent fatigue in residents is uncertain. ⋯ Coverage to allow a nap during an extended duty-hour shift can increase sleep and decrease fatigue for residents.
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Strong community linkages are essential to a health care organization's overall preparedness for emergencies. ⋯ In this baseline assessment, most hospitals reported substantial integration. However, results suggest that relationships between hospitals, public health departments, and other critical response entities are not adequately robust. Suggestions for enhancing linkages are discussed.