J Natl Med Assoc
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Coma, commonly known as "being unconscious" or "out cold," is a state of consciousness characterized by a total inability to perceive incoming stimuli. A retrospective phenomenologic study found that 10 of 36 control, 19 of 36 precare, and 20 of 36 aftercare subjects (49 of 108, or 45.4 percent) had experienced coma at least once during their lives. The implications of these findings are discussed.
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Coronary heart disease (CHD) is the leading cause of death among US blacks whose CHD mortality rates are among the highest in the world. Important to the advance of understanding the etiology, pathogenesis, and prevention of coronary heart disease is an examination of the epidemiology of coronary heart disease in blacks.
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A review of ten years of experience with traumatic diaphragmatic hernia, an often-missed injury, is presented. The unusual occurrence of a right diaphragmatic hernia following blunt trauma, which occurred in one patient, prompted this retrospective review. A high index of suspicion is still a safeguard against missing this injury. The mechanism of diaphragmatic tear with blunt trauma is described and modes of diagnosis and treatment are discussed.
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UNLIKE EMPLOYEES IN OTHER SECTORS OF THE ECONOMY, HEALTH CARE WORKERS ARE DIRECTED TOWARD ONE ULTIMATE GOAL: making people well and keeping them healthy. The development of collective bargaining and union activities during this century has had a great impact on all industries in the United States and the western world. However, only in recent years have workers in the health care sector been affected by the organized labor movement. ⋯ Even though most physicians continue to function as individual, entrepreneurial service providers and "professionals," physicians as a group are more frequently being seen as members of a utility like industry. Their importance to individuals and society as a whole, it can be argued, is second to none; if physicians refuse to work there can be no worse set of outcomes. To estimate the potential future impact of growing collective action on the part of physicians, this article explores the general historical developments.