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How Well Are Pulses Measured?

Although taking a radial pulse is considered to be an essential clinical skill, there have been few reports on how well it is measured in clinical practice, and how its accuracy and precision are influenced by rate, rhythm, and blood pressure. Methods This study is a retrospective quality audit carried out as part of a […]

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False and Misleading Information About Lyme Disease

  Recently, there has been considerable interest in the topic of fake news. For infectious diseases physicians, false and misleading information about the diagnosis and treatment of Lyme disease is not new. It is increasing in frequency and prominence, creating much confusion among primary care physicians and their patients. Persistent, unexplained subjective symptoms such as […]

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The Intention-to-Treat Analysis Is Not Always the Conservative Approach

The randomized trial design can be thought of as a means to answer 2 types of general questions: 1) what is the effect of assigning a treatment?; or 2) what is the effect of receiving a treatment? In public health, we are normally concerned with the first question—the effect of assigning a treatment. If we […]

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Where Have the Generalists Gone? They Became Specialists, Then Sub-Specialists.

At the onset of the 20th century, most practicing physicians had received their training in proprietary medical schools, many of which were essentially diploma mills.1 These schools offered a series of lectures over a 1-year period. A minority of physicians had attended university-based medical schools such as Johns Hopkins, which was established in 1893. There were only […]

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Mindfulness-Based Laboratory Reduction: Reducing Utilization Through Trainee-Led Daily ‘Time Outs’

Overuse of laboratory investigations is widely prevalent in hospitalized patients, leads to discomfort, and increases direct and indirect costs. Objective We implemented a simple, inexpensive, mindfulness strategy on our inpatient medical clinical teaching unit to reduce unnecessary laboratory orders through education, a forcing function, and daily structured laboratory “time outs.” Methods On a 26-bed unit […]

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