Archives of internal medicine
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Elective bilateral salpingo-oophorectomy (BSO) is routinely performed with hysterectomy for benign conditions despite conflicting data on long-term outcomes. ⋯ In this large prospective cohort study, BSO decreased the risk of ovarian cancer compared with hysterectomy and ovarian conservation, but incident ovarian cancer was rare in both groups. Our findings suggest that BSO may not have an adverse effect on cardiovascular health, hip fracture, cancer, or total mortality compared with hysterectomy and ovarian conservation.
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Comparative Study
Changes in medical students' views of internal medicine careers from 1990 to 2007.
The United States faces a shortage of primary care physicians and declining number of medical students choosing primary care careers. ⋯ More students in 2007 than in 1990 viewed IM as a potentially meaningful career. However, the 2007 students had higher debt, more negative perceptions of workload and stress in IM, and less career interest in general IM. To rebuild the generalist physician workforce, improving students' experience of IM in medical school is no longer sufficient. Bolder reform will be required to improve the educational pipeline, practice, and payment of generalist IM physicians.
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Effective collaboration and teamwork is essential to providing safe hospital care. The objective of this study was to assess the effect of an intervention designed to improve interdisciplinary collaboration and lower the rate of adverse events (AEs). ⋯ Structured Inter-Disciplinary Rounds significantly reduced the adjusted rate of AEs in a medical teaching unit.
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Multicenter Study Comparative Study
The optimal delivery of palliative care: a national comparison of the outcomes of consultation teams vs inpatient units.
Growing attention to end-of-life care has led to intensive efforts to provide better palliative care. However, it is not known whether palliative care is best provided by consultative teams or in dedicated units. ⋯ Care received in palliative care units may offer more improvements in care than those achieved with palliative care consultations.