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Michael K. Gould, MD, MSc; Anne D. Dembitzer, MD; Gillian D. Sanders, PhD; and Alan M. Garber, MD, PhD

Low-molecular-weight heparins are highly cost-effective for inpatient management of venous thromboembolism. This treatment reduces cost when small numbers of patients are eligible for outpatient management.

Topics: deep vein thrombosis, low-molecular-weight heparin, cost-effectiveness analysis, unfractionated heparin
  
Michael K. Gould, MD, MSc; Anne D. Dembitzer, MD; Ramona L. Doyle, MD; Trevor J. Hastie, PhD; and Alan M. Garber, MD, PhD

Low-molecular-weight heparin treatment reduces mortality rates after acute deep venous thrombosis. These drugs seem to be as safe as unfractionated heparin with respect to major bleeding complications and appear to be as effective in preventing thromboembolic recurrences.

Topics: deep vein thrombosis, low-molecular-weight heparin, unfractionated heparin, hemorrhage
  
Allison B. Rosen, MPH; Vance G. Fowler Jr., MD; G. Ralph Corey, MD; Stephen M. Downs, MD, MS; Andrea K. Biddle, PhD; Jennifer Li, MD; and James G. Jollis, MD

Within the limitations of existing empirical data, this study suggests that for patients with clinically uncomplicated catheter-associated Staphylococcus aureus bacteremia, the use of transesophageal echocardiography to determine therapy duration is a cost-effective alternative to 2- or 4-week empirical therapy.

Topics: bacteremia, catheter device, cost-effectiveness analysis, sensitivity analysis, endocarditis, transesophageal echocardiography, staphylococcus aureus ...
  
Brooke Swearingen, MD; Beverly M.K. Biller, MD; Fred G. Barker II, MD; Laurence Katznelson, MD; Steven Grinspoon, MD; Anne Klibanski, MD; and Nicholas T. Zervas, MD

Survival of patients treated for Cushing disease with current management techniques between 1978 and 1996 was better than the poor survival historically associated with this disorder.

Topics: cushing syndrome
  
Stephen C. Hines, PhD; Jacqueline J. Glover, PhD; Jean L. Holley, MD; Austin S. Babrow, PhD; Laurie A. Badzek, RN, JD; and Alvin H. Moss, MD

Patients generally do not want to participate in advance care planning with physicians. On the basis of face-to-face interviews with dialysis patients, this study found that most patients wanted to include their families more than their physicians in advance care planning.

Topics: dialysis procedure, advance care planning, hemodialysis
  

Ambulatory electrocardiographic monitors, particularly transtelephonic continuous-loop event recorders, aid in the diagnosis of symptomatic arrhythmias. These devices are also useful for monitoring the effectiveness and safety of antiarrhythmic medications.

Topics: cardiac arrhythmia, palpitations, ambulatory monitoring
  

The past decade has witnessed a dramatic expansion in the scope of mechanical and pharmacologic methods for opening occluded arteries in patients with myocardial infarction. This paper reviews data on the ability of six revascularization strategies to produce early, full, and sustained reperfusion.

Topics: stent, thrombolytic therapy, percutaneous transluminal coronary angioplasty, glycoprotein, angioplasty, intracoronary route
  
J. Emilio Carrillo, MD, MPH; Alexander R. Green, MD; and Joseph R. Betancourt, MD, MPH

In today's multicultural society, assuring high-quality health care for all patients requires that physicians understand how each patient's sociocultural background affects his or her health behavior and beliefs. This paper describes a cross-cultural curriculum designed to address these issues.

Topics: primary health care, social environment, negotiating
  
Jason H.T. Karlawish, MD; Timothy Quill, MD; Diane E. Meier, MD, for the ACP-ASIM End-of-Life Care Consensus Panel

Making palliative care decisions for a patient who lacks decision-making capacity presents several challenges. The case commentary provided in this paper shows that physicians can guide a highly emotional and personal process in a structured manner that has meaning for the patient, family, physician, and other caregivers.

Topics: decision making, palliative care, consensus
  

The cost-effectiveness papers by Rosen and Gould and their colleagues in this issue show that some cost-increasing technologies do indeed represent good value for money in the clinical uses for which they are evaluated.

Topics: money
  
Marie F. Johnson, MD

The last thing my nephew and his family needed was another physician. They needed their aunt, their sister, their sister-in-law, not a doctor in the family.

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Israel Heller, MD; Aharon Isakov, MD; and Marcel Topilsky, MD
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Jaya K. Rao, MD, MHS; Nancy B. Allen, MD; and Theodore Pincus, MD
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Anne Nettles, RN, MSN, CDE
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Mayer B. Davidson, MD
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Robert F. DeBusk, MD; Nancy Houston Miller, RN, BSN; and Jeffrey A. West, MD
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Ronald E. Aubert, PhD, MSPH; Janice Waters, RN, CDE; and William H. Herman, MD, MPH
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Thomas H. Lee, MD; and Carisi A. Polanczyk, MD
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James R. Johnson, MD
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Paul H. Edelstein, MD
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Topics: diet, science of nutrition, cancer
  
Topics: point of care testing, laboratory techniques and procedures
  
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Jonathan B. Zuckerman, MD; and Robert M. Kotloff, MD
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