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Traditional and molecular epidemiologic investigations indicate that tuberculosis was widely transmitted among inmates and guards in an urban jail. Aggressive measures to screen for active tuberculosis upon incarceration are important for preventing spread of disease in jails and to the surrounding community.
“White coat normotension”—elevated ambulatory blood pressure but normal office blood pressure—is associated with left ventricular mass and carotid wall thickness similar to those in patients with sustained hypertension. The association of white coat normotension with prognostically important target organ damage may partly explain the ability of high normal left ventricular mass and high normal clinical blood pressure to predict subsequent hypertension in patients with clinical normotension.
In apparently healthy postmenopausal women, little evidence was found to support the notion that previous infection (as measured by IgG antibody titers to Chlamydia pneumoniae, Helicobacter pylori, herpes simplex virus, and cytomegalovirus) is associated with subsequent risk for cardiovascular disease.
Identifying domestic abuse is difficult even for physicians committed to helping victims. The reports from expert physicians in this study illustrate the need to frame questions and develop indirect approaches that foster patient trust. It may be more productive to redefine the goals of universal screening so that compassionate asking in and of itself is the first step in helping battered patients.
Patients with primary pigmented nodular adrenocortical disease responded to dexamethasone with a paradoxical increase in glucocorticoid excretion during the Liddle test. This feature distinguishes such patients from those with the Cushing syndrome and may lead to timely detection of the Carney complex in asymptomatic patients.
Preoperative clinical severity and duration of illness are associated with the nature of outcomes after liver transplantation for familial amyloid polyneuropathy.
This evidence- and case-based discussion covers the clinical presentation of menopause, pretreatment assessment for hormone replacement therapy, benefits and risks of this treatment, common hormone replacement regimens and their side effects, and patient management.
In this issue, Jones and colleagues starkly document that a jail was the major reservoir of tuberculosis in their community. Their study shows that enhanced targeted screening may have a major effect on total tuberculosis morbidity.
Gerbert and colleagues' study in this issue found that even expert physicians do not always ask their patients about abuse. What keeps physicians from routinely inquiring about abuse, and what can be done to change this?
Significant new tools to prevent and treat influenza will become available to clinicians this year, and additional advances in vaccine are on the horizon. Currently available vaccine is effective, and the time to use it is now.
Master Gunnery Sergeant's medals commemorated duty on every continent. “Yes, Lieutenant,” he would answer. He was respectful, but I felt ludicrous. He was Experience, and I was Ingenue.
At that visit to my doctor, I learned what it is to be in need and be taken care of, and I was left with a new awareness of the awesome gift I had been given as a physician.
The articles selected for this Update cover asthma and chronic obstructive pulmonary disease, pulmonary infections, interstitial and occupational lung diseases, pulmonary embolism, solitary pulmonary nodules, and lung carcinoma.
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