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Articles 
Daniel E. Dunn, Patcharin Tanawattanacharoen, Piernicola Boccuni, Shoichi Nagakura, Spencer W. Green, Martha R. Kirby, Mysore S. Anil Kumar, Stephen Rosenfeld, and Neal S. Young Flow cytometric analysis is superior to the Ham test and permits concomitant diagnosis of paroxysmal nocturnal hemoglobinuria in about 20% of patients with myelodysplasia (a rate similar to that seen in patients with aplastic anemia). In myelodysplasia, the presence of cells that are deficient in glycosylphosphatidylinositol-anchored protein predicts responsiveness to immunosuppressive therapy.
Jaya K. Rao, Kimberly Mihaliak, Kurt Kroenke, John Bradley, William M. Tierney, and Morris Weinberger Patients with rheumatologic conditions frequently use complementary and alternative medicine (CAM). Severe pain and osteoarthritis predict regular use of CAM but do not predict a greater likelihood that a patient will discuss CAM use with physicians.
Agnes Y.Y. Lee, Jim A. Julian, Mark N. Levine, Jeffrey I. Weitz, Clive Kearon, Philip S. Wells, and Jeffrey S. Ginsberg A negative D-dimer test result in patients with cancer does not reliably exclude deep venous thrombosis because the negative predictive value of the test is significantly lower in these patients than in patients without cancer.
Richard D. deShazo, David F. Williams, and Edward S. Moak Imported fire ants now infest more than 310 million acres in the United States and Puerto Rico. With the two cases reported here, the total number of reported indoor fire ant attacks on humans since 1989 is 10. Eight of these attacks have been reported in the past 4 years.
Brief Communications
Sybil A. Tasker, John J. Treanor, William B. Paxton, and Mark R. Wallace Influenza vaccination is highly effective in HIV-1–infected patients and does not seem to be associated with substantial changes in viral load or CD4 cell count.
Edward W. Hook, III, Joan Stephens, and David M. Ennis A single 1.0-g dose of azithromycin seems to be efficacious for preventing syphilis in the sexual partners of infected persons.
Academia and Clinic
Paul Plsek Health care systems that do not deliver the desired results must be changed in some way. This paper describes ways to spark innovative thinking and generate creative ideas for health care system improvement.
Updates
William F. Clark, Gail A. Rock, Noel Buskard, Kenneth H. Shumak, Pierre LeBlond, David Anderson, David M. Sutton for the Canadian Apheresis Group* In 1997, the Canadian Apheresis Group reviewed data on 103 416 plasma exchange procedures that had been collected since 1980. Striking changes occurred over time in the frequency of use of apheresis, particularly for thrombotic thrombocytopenic purpura, myasthenia gravis, rheumatoid arthritis, and multiple sclerosis. In most instances, changes in the frequency of apheresis use correlated closely with published evidence on efficacy.
Perspectives
David M. Herrington The Heart and Estrogen/progestin Replacement Study (HERS) showed no overall effect of long-term use of estrogen plus progestin for secondary prevention of coronary heart disease in postmenopausal women. The key to understanding this finding, which contradicts previous research, may rest in the explanation of the time-trend data.
Editorials
Edward J. Benz, Jr. Cancer occurring in immunodeficient states is attributed to loss of immune surveillance. In this issue, Dunn and colleagues propose that immune attack might actually confer an ecological advantage on some neoplastic cells in their microenvironment.
On Being a Doctor
J. Randall Curtis The first call night of my third year of medical school wasn't the first time that I had felt intensely uncomfortable because of homophobic comments, but it was the most memorable.
On Being a Patient
Campion Quinn Two boys at play discover a real weapon among their imaginary ones.
Letters Clinical Model for Management of Pulmonary Embolism
Hemochromatosis and Vitamin C
ACI-TIPI Clinical Trial
Myocardial Abscess with Salmonella Infection
Solid Organ Transplantation
Steven L. Berk and James W. Myers
Donald J. Kennedy
Gordon Douglas, Jr.
J. Dennis Fortenberry
Brigid Kane
Linda Gunderson
Bhuvana Chandra
Norton J. Greenberger Among the most important topics attracting researchers' attention in 1998 were gastroesophageal reflux disease, the diagnosis and treatment of Helicobacter pylori infection, and the best management of patients with nonulcer dyspepsia. | ||||||||||||||||||||||||||||||||||||||||||||||||||||
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