Arch Intern Med
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In March 2004, the Chicago Department of Public Health was notified of a cluster of bloodstream infections with Klebsiella oxytoca and Enterobacter cloacae at a chemotherapy center. Our purpose was to identify the source of the outbreak and prevent further cases. ⋯ The injection of contaminated isotonic sodium chloride solution through the venous catheters of attendees at the clinic likely provided the opportunity for bloodstream infections in these 27 case patients. This outbreak highlights the need for continued emphasis on safe injection practices and suggests the need for guidelines and recommendations tailored to outpatient settings.
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Substantial evidence from laboratory studies indicates that green and black tea preparations may protect against various cancers. Few epidemiologic studies, however, have examined the relationship specifically between tea consumption and risk of ovarian cancer. ⋯ These results suggest that tea consumption is associated with a reduced risk of epithelial ovarian cancer in a dose-response manner.
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Although there is no generally accepted definition for the term short-term disability, chronic disability has been defined as disability lasting or expected to last at least 90 days according to a protocol that was established by the National Long-Term Care Survey. We evaluated the validity of the established protocol and determined the accuracy of prevalence estimates of chronic disability among elderly persons in the United States. ⋯ Our results threaten the validity of the currently established protocol for ascertaining chronic disability and suggest that the burden of chronic disability among elderly Americans has been substantially overestimated.
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Burnout is very common in internal medicine residents. Effective July 2003, all residents were restricted to work less than an average of 80 hours per week and no more than 30 hours of continuous duty for patient care and educational obligations. We evaluated rates of burnout in internal medicine residents before and after the implementation of the new work-hour restriction. ⋯ Burnout continues to be a major problem. Reducing hours may be the first step to reduce burnout but may also affect education and quality of care.
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The context in which patients consume health information has changed dramatically with diffusion of the Internet, advances in telemedicine, and changes in media health coverage. The objective of this study was to provide nationally representative estimates for health-related uses of the Internet, level of trust in health information sources, and preferences for cancer information sources. ⋯ The Health Information National Trends Survey data portray a tectonic shift in the ways in which patients consume health and medical information, with more patients looking for information online before talking with their physicians.