Rhode Island medical journal (2013)
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Increasing concern over the acute and long-term consequences of sports-related concussion has generated widespread interest and attention. This article provides an overview of concussion in athletes, including diagnostic and management considerations, and highlights the clinical challenges associated with repeated minor head trauma in sports. [Full article available at http://rimed.org/rimedicaljournal-2016-10.asp].
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Anti-vascular endothelial growth factor (anti-VEGF) drugs - ranibizumab, aflibercept, and off-label bevacizumab - are vital to the treatment of common retinal diseases, including exudative age-related macular degeneration (AMD), diabetic macular edema (DME), and macular edema (ME) associated with retinal vein occlusion (RVO). Given the high prevalence of AMD and retinal vascular diseases, anti-VEGF agents represent a large cost burden to the United States (US) healthcare system. ⋯ We found that current professional guidelines were limited in availability and lacked specific guidance on cost-based anti-VEGF drug selection. This represents a missed opportunity to encourage the practice of value-based medicine. [Full article available at http://rimed.org/rimedicaljournal-2016-05.asp, free with no login].
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There is currently an organ shortage crisis in the United States. This paper analyzes the magnitude of the problem, the organ procurement programs in other developed countries as compared to the US, and discusses the changes that can be made to address this problem. ⋯ In order to narrow the gap between the demand and supply of organs, steps need to be taken to improve the organ procurement infrastructure. The public needs to be educated about the dire need, the benefits and risks in organ donation, and living vs. deceased donation. [Full article available at http://rimed.org/rimedicaljournal-2016-05.asp, free with no login].
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Doctors in almost every branch of medicine encounter patients who are dying or have serious illnesses. Numerous studies, however, indicate that the education of physicians does not adequately prepare them for such patients. ⋯ We also found that exposure to dying individuals was significantly associated with many symptom management skills and more favorable attitudes toward palliative medicine. We therefore recommend that palliative care skills, which are relevant to all future physicians regardless of specialty, be incorporated throughout the AMS curriculum, and that more students be exposed to patients at end-of-life.
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Observational Study
Prevalence of Sedating Medication Use Among Older Drivers Presenting in the Emergency Department.
Adults over the age of 65 are involved in more motor vehicle collisions per mile driven than those under 65. ⋯ Given that none of the participants on sedating medications reported previous advice regarding the potential for these medications to cause driving impairment, this at-risk group might benefit from more thorough instruction to limit driving when using sedating medication.