Table of Contents

June 6, 2000; 132 (11)

Articles

  • Among patients who had total knee or total hip replacement and received 4 to 10 days of postoperative ardeparin prophylaxis, the cumulative incidence of symptomatic venous thromboembolism or death after hospital discharge was not significantly reduced by extended out-of hospital ardeparin prophylaxis.

  • In elderly patients, treadmill exercise testing provided prognostic information that was incremental to clinical data. After adjustment for clinical factors, workload was the only treadmill exercise testing variable strongly associated with outcome, and its prognostic effect was of the same magnitude in elderly and younger persons.

  • Twenty-four weeks of recombinant human relaxin therapy was associated with reduced skin thickening, improved mobility, and improved function in patients with moderate to severe diffuse scleroderma.

Brief Communications

  • Vascular endothelial growth factor (VEGF) may enhance vascular permeability in humans. In this study, 34% of patients undergoing VEGF gene transfer developed lower-extremity edema. This condition responded to oral diuretic therapy and did not seem to be associated with serious sequelae.

  • A 1-week course of trimethoprim–sulfamethoxazole was effective in HIV-infected patients with cyclosporiasis or isosporiasis. Although ciprofloxacin was not as effective, it is acceptable for patients who cannot tolerate trimethoprim–sulfamethoxazole.

Academia and Clinic

  • Despite substantial increases in the number of female faculty, reports of gender-based discrimination and sexual harassment remain common.

Reviews

  • Alcohol hangover, a common disorder, has substantial morbidity and societal cost. Appropriate management may relieve symptoms in many patients.

  • The methodologic limitations of several studies make it difficult to draw definitive conclusions about the efficacy of distant healing (prayer, mental healing, Therapeutic Touch, or spiritual healing). However, given that approximately 57% of 23 trials showed a positive treatment effect, the issue thus far merits further study.

Perspectives

  • In 1996, Port Arthur, Tasmania, was the site of the worst mass murder in Australian history. This paper highlights the contrast between the Australian response to this tragedy and how U.S. society responds to similar violence.

Editorials

  • In this issue, Heit and colleagues report on their important study of prolonged ardeparin sodium prophylaxis against venous thromboembolism after joint replacement surgery. What additional guidance for assessing the value of this treatment can be gained from this report?

  • The path leading from the bench to the clinic has been more tortuous than initially envisioned, but it now appears certain that immunotherapeutic approaches will play an expanding role in the management of lymphomas and other malignant conditions.

On Being a Doctor

  • The omniscience blithely promised by my residency training is easily deflated by the unadorned actualities of life. Where did I get the absurd notion that I might be a healer?

Letters

Medical Writings: Lingua Medica

  • Terms such as “compliance” and “adherence” are too facile to describe complex behavioral issues in medicine. They should be replaced by a language that is less succinct but richer in its description and analysis of human behavior.

Medical Writings: Book Notes

Ad Libitum

Book Listings

Medical Notices

Summaries for Patients