Arch Intern Med
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The principal motive for organ donation in the United States remains altruism. Surveys suggest that if the life-threatening and critical shortage of cadaveric donor organs were appropriately understood by the public, an altruistic response would lead to increased donation. However, despite intense educational efforts appealing to altruism, cadaveric organ donation has not increased substantially while the number of patients in need of a life-saving organ has grown markedly. ⋯ The donors in the focus groups, on the other hand, believed that the system worked equitably, although their knowledge about organ donation and transplantation was equivalent to that of nondonors. For organ donation to increase, efforts must be directed toward those who are not convinced that donation is for the common welfare. One way to increase organ donation is for physicians to educate their patients better regarding the equity and success of transplantation.
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A better understanding of the impact of vertebral fractures on physical functioning would help clinicians gauge the potential benefits of identifying patients at high risk and prevent vertebral fractures due to osteoporosis. ⋯ Recent vertebral fractures may lead to long-term poor physical functioning. Clinicians should take appropriate measures to identify those at risk, to prevent progression of osteoporosis, and to limit associated disability.
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Comparative Study
Thirty-day case-fatality rates for pulmonary embolism in the elderly.
Short-term race- and sex-specific case- fatality rates for pulmonary embolism (PE) in the elderly have not been studied previously, to our knowledge. ⋯ Our results indicate that there are racial and gender differences in 30-day case-fatality rates for PE in elderly patients. The high fatality risk associated with PE as a comorbid factor among common primary concurrent conditions and procedures calls attention to the need for more effective prophylaxis of deep vein thrombosis and rapid diagnosis and treatment of PE when it occurs.
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The risk of stroke in patients with atrial fibrillation can be significantly reduced with antithrombotic therapy. Despite this, many physicians remain hesitant to prescribe warfarin sodium or aspirin therapy for patients with atrial fibrillation. ⋯ About half of the patients with atrial fibrillation admitted to these academic hospitals had clinical risk factors that are associated with increased risk of stroke and no contraindications to anticoagulation. Antithrombotic therapy was underused in these patients.