The effect of risedronate on the risk of hip fracture in elderly women.
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Biomedical subjects
Publications and source records attributed to P C Royce.
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Physicians are spending increasingly less of their work week in the hospital. This is true of surgeons because they are performing more ambulatory surgery, often off the hospital premises, and for primary care physicians because they are delegating hospital care of their patients to others. What are the effects of this physician exodus on hospitals, patients, physicians, and medical education? Some of these consequences are explored, from disruptions in the continuity of care, to increase in practice productivity, to preparing undergraduates for the realities of medical practice.
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We determined the occurrence of palpable thyroid abnormalities in 214 persons with verified history of head and neck irradiation and in 243 concurrently examined, nonirradiated persons (control subjects). Examinations were performed by two physicians, each unaware of the medical history of the examinees and of the findings of the other examiner. Thyroid nodules, either single or multiple, occurred in 6.1% of irradiated persons and in 4.5% of control subjects (95% confidence interval of the difference, -2.6% to +5.7%). Thyroid enlargement without nodules occurred in 5.6% of irradiated persons and in 3.7% of control subjects (95% confidence interval of the difference, -2.0% to +5.8%). Thyroid cancer was detected in one irradiated and in two nonirradiated persons. Our controlled study did not find an excess number of thyroid abnormalities in previously irradiated subjects.
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