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Brian G. Feagan, MD; Cindy J. Wong, MSc; Alexandra Kirkley, MD; D.W.C. Johnston, MD; Frank C. Smith, MD; Paul Whitsitt, MD; Susan L. Wheeler, RN; and Catherine Y. Lau, PhD

Both a low- and a high-dose modified epoetin alfa regimen were effective compared with placebo in reducing allogeneic transfusions in patients undergoing hip arthroplasty. Patients who received high-dose epoetin alfa had the lowest transfusion rate.

Topics: blood transfusion, epoetin alfa, hip joint, arthroplasty, transfusion, iron, erythropoietin, hemoglobin
  
Karla Kerlikowske, MD; Patricia A. Carney, PhD; Berta Geller, EdD; Margaret T. Mandelson, PhD; Stephen H. Taplin, MD; Kathy Malvin, BA; Virginia Ernster, PhD; Nicole Urban, ScD; Gary Cutter, PhD; Robert Rosenberg, MD; and Rachel Ballard-Barbash, MD, MPH

Cancer detection rates in women who had a first-degree relative with a history of breast cancer were similar to those in women a decade older without a family history. The sensitivity of screening mammography was primarily influenced by age.

Topics: women, breast cancer, breast neoplasm screening, mammography, cancer
  
Carol H.F. Cheng, BS; Gillian D. Sanders, PhD; Mark A. Hlatky, MD; Paul Heidenreich, MD, MS; Kathryn M. McDonald, MM; Byron K. Lee, MD; Mary S. Larson, MD; and Douglas K. Owens, MD, MS

Radiofrequency ablation substantially improves quality of life and reduces costs when it is used to treat highly symptomatic patients with supraventricular tachycardia. Although the benefit of radiofrequency ablation has not been studied in less symptomatic patients, a small improvement in quality of life is sufficient to give preference to this therapy over drug therapy.

Topics: pharmacotherapy, supraventricular tachycardia, radiofrequency ablation
  
Mark I. Hainer, DO; Naoky Tsai, MD; Steven T. Komura, MD; and Charles L. Chiu, PharmD

Fatal hepatorenal failure may occur after the use of hydrazine sulfate. This fatal complication must be considered in anyone taking or contemplating the use of hydrazine sulfate.

Topics: hepatorenal syndrome, hydrazines, sulfate
  
Kazunori Ohnishi, MD; Hitoshi Yoshida, MD; Kazuyuki Shigeno, MD; Satoki Nakamura, MD; Shinya Fujisawa, MD; Kensuke Naito, MD; Kaori Shinjo, MD; Yota Fujita, MD; Hirotaka Matsui, MD; Akihiro Takeshita, MD; Shiho Sugiyama, MD; Hiroshi Satoh, MD; Hajime Terada, MD; and Ryuzo Ohno, MD

Cardiac toxicity occurs during arsenic trioxide therapy in patients with acute promyelocytic leukemia. Such patients should be monitored for prolonged QT intervals and ventricular arrhythmia.

Topics: tachycardia, ventricular, qt interval, acute promyelocytic leukemia, arsenic trioxide, prolonged qt interval ...
  

This paper aims to help clinicians improve the care provided to patients in the intensive care unit when decisions are made to limit life-sustaining treatment.

Topics: intensive care unit, withholding treatment, ventilators, mechanical
  
Martin Black, MD; and Hamid Hussain, MD

In this issue, Hainer and colleagues describe a patient who died of hepatic necrosis after taking hydrazine sulfate purchased over the Internet. Although this case will do little to dampen the ardor of hydrazine enthusiasts, there seems little justification for the easy availability of this substance and its unsupervised use.

Topics: cancer, hydrazines, internet, isoniazid, liver
  
Richard A. Parker, MD

She was born at home like the first child, but her eyes looked different, slightly glazed. At first, everything seemed normal. But all was not right.

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Martin L. Brown, PhD; Benjamin F. Hankey, ScD; and Rachel Ballard-Barbash, MD, MPH
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David Gerard De Marco, SJ, MD
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Seiko Okada, MD; Shinji Teramoto, MD; and Rokuro Matsuoka, MD
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Savino Bruno, MD; Andrea Crosignani, MD; and Giovanni Battista Pinzello, MD
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Kent E. Kester, MD; Govinda S. Visvesara, PhD; and Peter McEvoy, MD
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The artwork of Joseph Beuys reminds us as practicing physicians that the patient is always more than a distinct disease classified by the reductionist methods of the natural sciences.

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Murray Grossman, MD
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Brett Cucchiara, MD
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Jack Coulehan, MD
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Topics: erythropoietin, blood transfusion, hip replacement arthroplasty
  
Topics: mammography, women, breast cancer, family history
  
Topics: supraventricular tachycardia, radiofrequency ablation, cost-effectiveness analysis
  
Topics: cancer, kidney failure, hydrazines, liver, sulfate
  
Topics: leukemia, arsenic trioxide, cardiac rhythm
  
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William J. Hall, MD; and Rosanne M. Leipzig, MD, PhD

Among the topics addressed in this Update are insomnia, delirium, dementia and feeding tubes, dizziness, and predicting disability in old age.

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Mark E. Josephson, MD; David J. Callans, MD; and Alfred E. Buxton, MD

The authors discuss the current indications for the use of implantable cardioverter-defibrillators in primary and secondary prevention of sudden cardiac death.

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