Differences between ethnic groups in use of cardiovascular procedures narrowed markedly once a serious illness developed and adequate insurance coverage was ensured. The disparity was eliminated in patients with previous Medicare insurance or a stronger indication for a procedure.

Although revascularization procedures are substantially underused, the rate of use did not vary by sex, ethnic group, or payer status among patients treated in hospitals that provide coronary artery bypass graft surgery and percutaneous transluminal coronary angioplasty. However, underuse was significantly greater in hospitals that do not provide these procedures, particularly among uninsured persons.

Response to immunosuppression in patients with aplastic anemia is independent of age, but treatment is associated with increased mortality in older patients.

In fall 1996, a small cluster of Escherichia coli O157:H7 infections was linked to unpasteurized apple juice. This study found that standard procedures at a plant that produces unpasteurized juices were inadequate to eliminate contamination with E. coli O157:H7. This outbreak showed that unpasteurized juices must be considered a potentially hazardous food.

In spring 1996, an outbreak of cyclosporiasis associated with fresh Guatemalan raspberries occurred in the United States and Canada. In spring 1997, another outbreak took place. These outbreaks highlight the need for better understanding of the biology and epidemiology of Cyclospora cayetanensis and for stronger prevention and control measures to ensure the safety of produce that is eaten raw.

Nasal carriage was found to be an important risk factor for Staphylococcus aureus infection in HIV-infected patients.

In this study, mixed cryoglobulinemia was common among patients with HIV-1 infection.

The articles by Daumit and Leape and their colleagues in this issue indicate that health care access, quality, and equity are related. As we continue to strive to reduce ethnicity-based disparities in access to health care, we should not neglect the equally important issue of assuring that those services are delivered in an appropriate, timely, and effective manner.

In this issue, Herwaldt and colleagues conclude that the 1997 outbreak of raspberry-associated cyclosporiasis highlights the need for improved surveillance for foodborne illnesses. Although this conclusion may seem obvious, it is only a small piece of the public health effort needed to reduce the incidence of foodborne illness.

Matthew Shepard was found tied to a fence on the prairie east of Laramie, Wyoming, unconscious after a brutal beating. He died several days later. A physician from Laramie reflects on how Matt's murder affected this small community.

What do physicians carry in their white coat pockets?