Arch Intern Med
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To determine whether blacks in the First National Health and Nutrition Examination Survey Epidemiologic Follow-up Study remained at increased risk for cerebral infarction after adjusting for stroke risk factors and sociodemographic factors. ⋯ These results indicate that much of the increased risk for cerebral infarction experienced by blacks can be explained by their higher prevalence of stroke risk factors, especially diabetes, hypertension, and lower educational attainment. Younger blacks, however, may still be at increased risk after adjusting for stroke risk factors.
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Nosocomial bloodstream infections occur at a rate of 1.3 to 14.5 per 1000 hospital admissions and are believed to lead directly to 62,500 deaths per year in the United States. Measures of the incidence and the proportion of all hospital deaths related to deaths from these infections provide estimates of their impact. The objectives of the study were to characterize the secular trends in nosocomial bloodstream infection at a single institution and to estimate the population-attributable risk for death among patients experiencing the infection. ⋯ The incidence, the etiologic fraction, and the population-attributable risk for death among patients experiencing nosocomial bloodstream infections increased progressively during the last decade.
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While there has been extensive research on interventions designed to increase knowledge of research methods in the setting of journal clubs, little is known regarding other features that are of potential importance. To my knowledge, no research to date has described the attributes of journal clubs associated with high resident attendance and the avoidance of periodic abandonment. I sought to determine how journal clubs in postgraduate programs in internal medicine are organized and to identify the features associated with high attendance and continuous existence. ⋯ If residency journal club success is defined as having high attendance or long, continuous existence, then success is associated with smaller residency programs, making attendance mandatory, promoting a journal club independent of faculty, providing formal teaching of critical appraisal skills, making food available, and emphasizing original research articles. Residency programs in internal medicine seeking to establish journal clubs with long, continuous existence or high attendance should focus on these attributes.
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The literature on outcomes of intensive care for the elderly with regard to intensive care unit utilization, mortality, hospital costs and charges, and quality of life after intensive care were reviewed. Publications in the English literature, which evaluated intensive care and included elderly populations, were obtained from review of Index Medicus and MEDLINE. ⋯ A therapeutic trial and appropriately discontinuing life support may lead to better utilization of intensive care. Additional data are needed on long-term mortality and quality of life after hospital discharge.