JAMA : the journal of the American Medical Association
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Although using a helmet is assumed to reduce the risk of head injuries in alpine sports, this effect is questioned. In contrast to bicycling or inline skating, there is no policy of mandatory helmet use for recreational alpine skiers and snowboarders. ⋯ Wearing a helmet is associated with reduced risk of head injury among snowboarders and alpine skiers.
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Privileging involves the granting of permission to perform specific professional activities under the jurisdiction of a governing body's (hospital) authority. In 1951, the Joint Commission on the Accreditation of Hospitals (later renamed the Joint Commission on Accreditation of Healthcare Organizations) was formed to codify the process of hospital assessment. In the early part of the 20th century, a parallel process was being undertaken by the medical specialties to evaluate and recognize competence among physicians through the creation of specialty boards. ⋯ These results raise issues regarding the manner in which board certification is used or not used by hospitals in their efforts to ensure the practice of high-quality care within their institutions. The premise for recertification is the need to assure the public of continued competence of physicians over the course of their professional careers. Increased attention by the public and regulatory agencies regarding patient safety and quality of care will likely have an impact on hospital privileging processes.
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The adamantanes, amantadine and rimantadine, have been used as first-choice antiviral drugs against community outbreaks of influenza A viruses for many years. Rates of viruses resistant to these drugs have been increasing globally. Rapid surveillance for the emergence and spread of resistant viruses has become critical for appropriate treatment of patients. ⋯ The high proportion of influenza A viruses currently circulating in the United States demonstrating adamantane resistance highlights the clinical importance of rapid surveillance for antiviral resistance. Our results indicate that these drugs should not be used for the treatment or prophylaxis of influenza in the United States until susceptibility to adamantanes has been reestablished among circulating influenza A isolates.
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Randomized Controlled Trial Multicenter Study Comparative Study
Sirolimus- vs paclitaxel-eluting stents in de novo coronary artery lesions: the REALITY trial: a randomized controlled trial.
Compared with bare metal stents, sirolimus-eluting and paclitaxel-eluting stents have been shown to markedly improve angiographic and clinical outcomes after percutaneous coronary revascularization, but their performance in the treatment of de novo coronary lesions has not been compared in a prospective multicenter study. ⋯ ClinicalTrials.gov Identifier: NCT00235092.