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Articles 
David B. Badesch, Victor F. Tapson, Michael D. McGoon, Bruce H. Brundage, Lewis J. Rubin, Fredrick M. Wigley, Stuart Rich, Robyn J. Barst, Pamela S. Barrett, Kenneth M. Kral, Maria M. Jöbsis, James E. Loyd, Srinivas Murali, Adaani Frost, Reda Girgis, Robert C. Bourge, David D. Ralph, C. Gregory Elliott, Nicholas S. Hill, David Langleben, Robert J. Schilz, Vallerie V. McLaughlin, Ivan M. Robbins, Bertron M. Groves, Shelley Shapiro, Thomas A. Medsger, Jr., Sean P. Gaine, Evelyn Horn, James C. Decker, and Katharine Knobil Continuous epoprostenol therapy improves exercise capacity and cardiopulmonary hemodynamics in patients with pulmonary hypertension due to the scleroderma spectrum of disease.
Horst Olschewski, H. Ardeschir Ghofrani, Thomas Schmehl, Jörg Winkler, Heinrike Wilkens, Marius M. Höper, Jürgen Behr, Franz-Xaver Kleber, Werner Seeger for the German PPH Study Group* Inhaled iloprost may offer a new therapeutic option for improvement of hemodynamics and physical function in patients with life-threatening pulmonary hypertension and progressive right-heart failure that is refractory to conventional therapy.
Lieng H. Ling, Jae K. Oh, Jerome F. Breen, Hartzell V. Schaff, Gordon K. Danielson, Douglas W. Mahoney, James B. Seward, and A. Jamil Tajik In contrast to common belief, pericardial calcification was noted to be a frequent finding in patients with constrictive pericarditis. It is often associated with idiopathic disease and other markers of disease chronicity and is an independent predictor of increased perioperative mortality rates.
Ezekiel J. Emanuel, Diane L. Fairclough, Julia Slutsman, and Linda L. Emanuel Substantial care needs are an important cause of the economic and noneconomic burdens imposed by terminal illness. Through an empathetic approach, physicians may be able to ameliorate some of these burdens.
Medicine and Public Issues
Lois Snyder and Arthur L. Caplan The five papers on assisted suicide in this issue should help advance the dialogue about this difficult ethical subject and should be of assistance to physicians who grapple with these issues in practice, not just on paper.
Franklin G. Miller, Joseph J. Fins, Lois Snyder for the University of Pennsylvania Center for Bioethics Assisted Suicide Consensus Panel This paper uses three illustrative cases to examine leading arguments for and against the recognition of a fundamental difference between physician-assisted suicide and refusal of life-sustaining treatment.
Arthur L. Caplan, Lois Snyder, Kathy Faber-Langendoen for the University of Pennsylvania Center for Bioethics Assisted Suicide Consensus Panel The debate about assisted suicide guidelines involves several questions: What goals are guidelines intended to serve? Who should formulate guidelines? Can guidelines be practical? This paper explores these and other questions as physician-assisted suicide becomes legal.
Kathy Faber-Langendoen, Jason H.T. Karlawish for the University of Pennsylvania Center for Bioethics Assisted Suicide Consensus Panel The discussion in this paper defines both the necessity and limits of the physician's role in assisted suicide by asking whether assisted suicide should be only physician assisted. Although physician involvement is necessary, the authors argue that it is not sufficient to ensure that patients requesting assisted suicide receive the best care.
Timothy E. Quill, Barbara Coombs Lee, Sally Nunn for the University of Pennsylvania Center for Bioethics Assisted Suicide Consensus Panel Methods for easing death include standard pain management, forgoing life-sustaining therapy, voluntarily stopping eating and drinking, terminal sedation, and physician-assisted suicide. This paper uses summaries of real clinical cases to illustrate how and when each of these practices might be chosen.
James A. Tulsky, Ralph Ciampa, Elliott J. Rosen for the University of Pennsylvania Center for Bioethics Assisted Suicide Consensus Panel The authors articulate some of the conceptual challenges to assisted suicide inherent in an era of legalization and provide a framework for physicians to use when responding to requests for assistance in dying.
Editorials
Alfred P. Fishman Two studies in this issue tackle treatment of secondary pulmonary hypertension with intravenous prostacyclin (Badesch and colleagues) and treatment of primary pulmonary hypertension with inhaled iloprost, the stable analogue of prostacyclin (Olschewski and colleagues). Despite their limitations, these studies are pioneering efforts in different stages of evolution.
On Being a Doctor
Walter J. Kade Within months after the Death with Dignity Act became law in Oregon, I received a call from the parents of a patient of mine requesting that I assist their daughter in her death.
Letters Toward Evidence-Based Statistics
Cost-Effectiveness of Low-Molecular-Weight Heparins for Deep Venous Thrombosis
Antiretroviral Therapy for Pregnant HIV-Infected Women
A New Role of Upper Gastrointestinal Endoscopy
Methylphenidate for Cerebral Palsy with Choreoathetosis
FK506-Induced Autoimmune Diabetes
Joel G. Ray
Michelle Berlin
Paul T. Kefalides
Eugene R. Schiff This Update addresses key research in the areas of viral hepatitis, drug-induced hepatotoxicity, and noninvasive diagnostic assessment using magnetic resonance cholangiography. | ||||||||||||||||||||||||||||||||||||||||||||||||
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