Articles: patients.
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COMMENTS FOR PROFESSOR BARRIE R. CASSILETH: I have enjoyed reading the two issues of The Oncologist I've received so far. I would like to make some comments on Dr. ⋯ But most oncologists, like Dr. Quah, indeed are faced with trying to advise patients about therapies for which there is little hard evidence. The best guiding principles at this point are to discourage remedies that promise cancer cure or are promoted for use instead of mainstream treatment, encourage non-invasive, comforting, complementary (adjunctive) therapies such as massage, green tea and qi gong, and check medical journals and newspapers for warnings such as those issued recently for Ma Huang (ephedrine), a still-common ingredient in herbal remedies widely available through catalogs and in health food stores.
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". we must guard against the acquisition of unwarranted influence, whether sought or unsought, by the military industrial complex." Dwight D. Eisenhower, 34th President of the United States (1953-1961). Farewell Address, January 17, 1961. ⋯ It is our responsibility to tout our accomplishments, admit our failures, and provide progressively better basic and clinical research with an eye toward future improvements in outcome. We must not be seen as yet another special interest come to drink at the well of public spending, but as advocates for the public good. If we fail to become important to those who control medical spending, we will be unable to make any important long-term contribution to those who matter most - our patients.
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Dear Colleague: I remember, but just barely, what it was like to practice medicine in the first half of this century. My Dad was a general practitioner in a very small farming community in central Illinois, with a hospital of six beds and a trusting clientele. His patients thought he knew how to do everything: deliver babies, set broken bones and take out an appendix. ⋯ In this journal, we hope to put the best and latest information on cancer management before our readership, to prepare them for the future, and to do their best as a team for every patient. To this end, we hope to challenge the reader to understand what is new and better, and to let you glimpse the future, not only in terms of research, but also in terms of new team approaches to disease management. We hope to explore how cancer medicine could be and will be practiced as we pass through the economic revolution and return to the future.
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Am. J. Respir. Crit. Care Med. · Jan 1996
Comparative StudyResource use implications of do not resuscitate orders for intensive care unit patients.
This study describes the use of do not resuscitate (DNR) orders for ICU patients in four northeastern U. S. teaching hospitals and investigates the relationship between DNR orders and length of stay. The use of detailed data from the mortality probability model (MPM II) study on 6,290 consecutive ICU admissions to general adult medical and surgical ICUs during 1989 through 1991 allows us to control for severity of illness and the time during the ICU stay at which the DNR order was entered. ⋯ Nonsurvivors with early (first 24 h) DNR had shorter mean and median ICU and hospital stays than the comparison group of non-DNR patients. The percentage of patients with very long ICU (> 30 d) and hospital (> 60 d) stays was smaller among DNR patients. The use of DNR orders, particularly early in the ICU stay, may be associated with significant resource use reduction for an identifiable group of patients.
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Cognitive neuropsychology · Jan 1996
The Living/Nonliving Dissociation is Not an Artifact: Giving an A Priori Implausible Hypothesis a Strong Test.
Some brain-damaged patients seem to have more difficulty retrieving information about living things than about nonliving things. Does this reflect a distinction between two different underlying brain systems specialised for knowledge of living and nonliving things, or merely a difference in the diffculty of retrieving these two kinds of knowledge from a single semantic memory system ? Two recent articles (Funnell & Sheridan, 1992; Stewart, Parkin, & Hunkin, 1992) have concluded the latter, on the basis of experiments in which various determinants of naming difficulty were matched for living and nonliving things and the previously observed dissociation was found to vanish. We argue that these null effects are due to insufficient power, and that knowledge of living things can be selectively impaired. In support of this, we use the same stimulus materials, design, and data analysis as did Funnell and Sheridan (1992), with two different subjects having the same aetiology and general behaviour in the domain of semantic memory, and show that: (1) when, like the authors of these articles, we use only a single replication of each item, no effect is found, and (2) when we use more replications of the same items, highly significant differences between.