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Articles 
James E. Peacock, Jr., Deirdre A. Herrington, James C. Wade, Hillard M. Lazarus, Michael D. Reed, Jane W. Sinclair, Daniel C. Haverstock, Steven F. Kowalsky, David D. Hurd, Deborah A. Cushing, Colleen P. Harman, and Gerald R. Donowitz Empirical therapy with an aminoglycoside and a ß-lactam remains common for febrile neutropenic patients. Concerns about aminoglycoside-induced ototoxicity and nephrotoxicity have led to studies of alternate regimens. In this study, ciprofloxacin–piperacillin was as safe and effective as tobramycin–piperacillin for empirical therapy of neutropenic fever.
Harry P. Selker, Joni R. Beshansky, John L. Griffith for the TPI Trial Investigators* Although its effect was minimal on patients with high baseline reperfusion rates, the electrocardiograph-based Thrombolytic Predictive Instrument increased use and timeliness of reperfusion in often-missed groups and when involved physicians were off site.
Michael Pignone, Somnath Saha, Tom Hoerger, and Jeanne Mandelblatt Screening for colorectal cancer appears cost-effective compared with no screening, but a single optimal strategy cannot be determined from the currently available data. Additional data and additional analyses are necessary.
Brief Communications
Philip C. Johnson, L. Joseph Wheat, Gretchen A. Cloud, Mitchell Goldman, Dan Lancaster, David M. Bamberger, William G. Powderly, Richard Hafner, Carol A. Kauffman, William E. Dismukes for the U.S. National Institute of Allergy and Infectious Diseases Mycoses Study Group* In patients with moderate to severe histoplasmosis associated with AIDS, the preferred treatment has been the deoxycholate formulation of amphotericin B. However, serious side effects are associated with this drug. This study found that liposomal amphotericin B was less toxic than amphotericin B and was associated with improved survival.
Academia and Clinic
David W. Bates This article analyzes the case of a patient with iatrogenic hypoglycemia due to administration of the wrong medication. The institution's "root-cause analysis" of the factors contributing to this particular adverse event and the institution's response are discussed, and the literature on preventing medication errors is reviewed.
Joanne Lynn, Kevin Nolan, Andrea Kabcenell, David Weissman, Casey Milne, Donald M. Berwick for the End-of-Life Care Consensus Panel* Most people in developed countries will live with a serious, eventually fatal, chronic condition for months or years before dying, yet the delivery of health care services has only recently begun adapting to this reality. Lynn and colleagues discuss a composite case study in a nursing home setting, which builds on experience with multisite collaborative efforts and introduces quality improvement methods in the context of end-of-life care.
Clinical Guidelines
U.S. Preventive Services Task Force* The U.S. Preventive Services Task Force strongly recommends that clinicians routinely provide colorectal cancer screening for all adults 50 years of age or older.
Michael Pignone, Melissa Rich, Steven M. Teutsch, Alfred O. Berg, and Kathleen N. Lohr This systematic review supports the U.S. Preventive Services Task Force's position on screening for colorectal cancer.
Editorials
Lindsey R. Baden and Robert H. Rubin The management of the patient with cancer who has chemotherapy-induced neutropenia and fever has changed markedly over the past four decades. Empirical antimicrobial therapy is now the standard of care for any patient with cancer and neutropenia who has unexplained fever, rigors, or subtler signs of sepsis. The study by Peacock and colleagues in this issue adds significantly to our understanding of the effect of this approach in patients with cancer.
Sanjay Saint, Benjamin A. Lipsky, and Susan Dorr Goold More than four decades ago, Dr. Paul Beeson persuasively argued against routine use of indwelling urinary catheters in hospitalized patients, making the "case against the catheter." This advice remains relevant today.
On Being a Doctor
Neil Nakadate My father's precise, thorough ways as a fly fisherman told you what to expect of his ways in the practice of anesthesiology.
Letters Physicians and Joint Negotiations
Blue Light and Milk
Fruit and Vegetable Intake and Coronary Heart Disease
Questioning the Treatment of Venous Thromboembolism
Rapid-Onset Type 1 Diabetes Mellitus without Pancreatic Exocrine Dysfunction
Hepatotoxicity after Prophylaxis with a Nevirapine-Containing Antiretroviral Regimen
Correction: The Reliability of Medical Record Review for Estimating Adverse Event Rates
Catherine V. Caldicott
Rita Charon
Loreen Herwaldt
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