Minnesota medicine
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In 2008, the Minnesota Medical Association created a task force to develop a standardized Physician/Provider Orders for Life-SustainingTreatment (POLST) form that could be used throughout Minnesota. Whereas advance directives are created by patients to communicate their wishes about end-of-life care to a physician or other health care provider, POLST forms are used by a physician (or other designated health care provider) to document and communicate a person's end-of-life wishes to other health care professionals, including other physicians. Several states have adopted POLSTforms. This article describes the effort to create a POLST initiative and form in Minnesota.
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In 2007, the American Cancer Society published guidelines for using breast MRI to screen women who were at high risk for breast cancer. Although breast MRI, which is typically used as an adjunctto mammography, is highly sensitive for detecting breast cancers, its use is somewhat controversial for a number of reasons including its cost and lack of specificity. This article describes the indications for breast MRI and discusses the pros and cons of using it to screen women for cancer and evaluate the extent of disease in women who are newly diagnosed.
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Publicized cases of errant high radiation exposure delivered to patients undergoing diagnostic imaging have led to heightened awareness and scrutiny of the costs and benefits of imaging by physicians, the public, and policymakers. The statistical risks associated with the ever-increasing utilization of modalities employing damaging ionizing radiation across the population are compounded by the development of the latest generation of devices, which are capable of delivering greater radiation doses than their predecessors for comparable diagnostic applications. This article reviews the fundamental concepts and risks of medical radiation exposure, trends in imaging utilization, and the role of radiologists and their physician colleagues in managing and appropriately utilizing imaging for patient diagnosis.