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The pros and cons of the annual physical are discussed in two perspective pieces published online Oct. 14 in the New England Journal of Medicine.

Pros and Cons of Annual Physical Discussed

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Pros include fostering of therapeutic relationship; cons include lack of evidence for benefits
Intrinsic qualities of safety-net hospitals

Safety-Net Hospitals Have Higher Costs, Worse Outcomes

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Found to have higher mortality, readmission, surgical costs after controlling for patient factors
Lower-income patients with cancer are less likely to participate in clinical trials

Lower-Income Cancer Patients Less Likely to Participate in Trials

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Trial participation decreases with decreasing annual household income
Coadministering tetanus toxoid

Coadministering Tdap, Flu Vaccines Safe in Pregnancy

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No difference in adverse events, birth outcomes with concomitant versus sequential vaccination
Complications from epidural and spinal anesthetic procedures during cesarean deliveries dropped 25 percent over a recent 10-year period

Epidural-Related Complications Down for C-Sections

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Certain complications down 25 percent over decade
Patients undergoing hysteroscopic sterilization have more than a 10-fold higher risk of undergoing reoperation compared with patients undergoing laparoscopic sterilization

Hysteroscopic Sterilization Tied to Higher Reoperation Risk

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But similar risk of unintended pregnancy with hysteroscopic, laparoscopic methods
Cancer survivors tend to have worse dietary quality than the general population

Cancer Survivors Often Have Poor Dietary Quality

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Worse intake patterns than matched individuals from general population for empty calories, fiber
Women in certain racial/ethnic groups are more likely to be diagnosed with more advanced breast cancer

Advanced-Stage Breast CA More Likely in Certain Racial Groups

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African-American, white Hispanic women more likely to receive non-guideline-concordant treatment
Black and Hispanic women have significantly higher readmission rates than white women after childbirth

Racial Disparity Seen in Childbirth-Related Readmission

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Blacks, Hispanics have higher readmission rates after both vaginal birth, C-section
Maternal midpregnancy measures of glucose and insulin are associated with two different congenital heart disease phenotypes

Maternal Glucose Levels Linked to Two CHD Phenotypes

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Correlations with odds of tetralogy of Fallot but not dextrotransposition of the great arteries