Annals of internal medicine
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Practice Guideline
Screening for chlamydial infection: U.S. Preventive Services Task Force recommendation statement.
Update of 2001 U.S. Preventive Services Task Force (USPSTF) recommendations about screening sexually active adolescents and adults for chlamydial infection. ⋯ Screen for chlamydial infection in all sexually active nonpregnant young women age 24 years or younger and for older nonpregnant women who are at increased risk. (A recommendation) Screen for chlamydial infection in all pregnant women age 24 years or younger and in older pregnant women who are at increased risk. (B recommendation) Do not routinely screen for chlamydial infection in women age 25 years or older, regardless of whether they are pregnant, if they are not at increased risk. (C recommendation) Current evidence is insufficient to assess the balance of benefits and harms of screening for chlamydial infection for men. (I statement).
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In 2002, the Accreditation Council on Graduate Medical Education enacted regulations, effective 1 July 2003, that limited work hours for all residency programs in the United States. ⋯ The work-hour regulations were associated with decreased short-term mortality among high-risk medical patients in teaching hospitals but were not associated with statistically significant changes among surgical patients in teaching hospitals.
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Meta Analysis
Beta-blockers and progression of coronary atherosclerosis: pooled analysis of 4 intravascular ultrasonography trials.
In patients with myocardial infarction, beta-adrenergic blockers reduce recurrent myocardial infarction and total mortality rates. However, whether a direct influence of beta-blockers on coronary atherosclerosis contributes to reduced recurrent myocardial infarction and total mortality rates is not known. ⋯ The analysis demonstrates that beta-blockers can slow progression of coronary atherosclerosis. The findings provide additional support for the current clinical guidelines advocating long-term use of beta-blockers to treat most forms of coronary artery disease.
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Physicians in intensive care units have withdrawn life support in incapacitated patients who lack surrogate decision makers and advance directives, yet little is known about how often this occurs or under what circumstances. ⋯ Incapacitated patients without surrogates accounted for approximately 1 in 20 deaths in intensive care units. Most life-support decisions were made by physicians without institutional or judicial review.