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The ethical foundation on which my medical practice is based was recently shaken by an episode involving the intrusion of managed care into my practice. With the patient's informed consent, I prescribed a medication that I knew would not work.

As we approach the 21st century, specialty training programs in dermatology are feeling increasing pressures that have begun to erode clinical teaching. Full-time faculty members are being asked to spend more time in patient care to support an…

BACKGROUND: The explosion of medical knowledge, the influence of communications technology, and the pressures for health care reform challenge dermatologists to learn efficiently and teach effectively. OBSERVATIONS: The vast body of material on…

Governmental incentives to stimulate the "meaningful use" of electronic medical records and future disincentives for Medicaid and Medicare provide an impetus for dermatologists to consider adding this technology to their clinical practice.…

Inadvertent drug substitution occurred in several instances in our practices due to the combination of the physician's illegible handwriting on prescriptions and the pharmacist's misinterpretation of subtle clues, which might have prevented the…

Dogs and cats are the 2 most common household pets. However, they may be a direct or indirect source of human infections. This article aims to familiarize physicians with some common and uncommon bacterial, rickettsial, parasitic, and fungal zoonotic…

OBJECTIVE: To determine how other program directors use the American Board of Surgery In-Training Examination (ABSITE) scores in the resident evaluation process. DESIGN: A cover letter and a printed one-page survey of eight questions about individual…

OBJECTIVES: To determine the accuracy and cost-effectiveness of nuclear scintigraphy for the diagnosis and localization of gastrointestinal (GI) bleeding and to determine whether nuclear scintigraphy accurately predicts the results of angiography.…

Historians have suggested that US president Andrew Jackson (1767-1845) experienced lead and mercury poisoning following his therapeutic use of calomel (mercurous chloride) and sugar of lead (lead acetate). To evaluate these claims, we performed…

Importance: Increased rates of autoimmune conditions have been reported in association with systemic lupus erythematosus (SLE). Little is known about coexisting autoimmune conditions in patients with cutaneous lupus erythematosus (CLE) without SLE.…

In this case and commentary, a patient's request to be treated for depression without a stigmatizing diagnostic label of bipolar II disorder challenges a clinician's obligation to provide a clinically and ethically appropriate diagnosis and safe…

At least 29 species of fossil primates have been referred to fruit, nectar, and/or exudate feeding dietary niches. Many studies have detailed the morphological correlates of fruit feeding in comparison to insectivory and folivory. In contrast, few…

Recognition of disease in the archeologic record is facilitated by characterization of the skeletal impact of documented (in life) disease. The present study describes the osteological manifestations of leukemia as identified in the skeletons of two…

A controlled study of the relationship of two standard clinical indicators of osteoarthritis and porosity failed to demonstrate a relationship. Porosity appears to be a curiosity that has no clinical correlation and is not a sign of an identifiable…

Primate hands can be classified into two broad categories on the basis of ray proportions and other features. Ectaxonic hands are characterized by a longer fourth ray and are found in most strepsirhines. Most haplorhines possess mesaxonic hands which…

This study was conducted to determine whether individual bony lesions are specific for recognizing multiple myeloma and thereby distinguish it from metastatic cancer and leukemia. The lytic skeletal lesions of multiple myeloma are characterized by…

Slight variation in manifestation of different diseases may allow a single individual with one disease to mimic the "classic" appearance of another, as evidenced by the frequent confusion of spondyloarthropathy with rheumatoid arthritis. Analysis of…

In the mustached bat, combination-sensitive neurons display integrative responses to combinations of acoustic elements in biosonar or social vocalizations. One type of combination-sensitive neuron responds to multiple harmonics of the…

The surface epithelium of 28 gallbladders removed during elective cholecystectomies and pathology collection was studied ultrastructurally. Focusing on 10 of the 28 cases that were diagnosed as cholecystitis, we found that the epithelium displayed…

The Angelchik prosthesis is a silicone-filled, doughnut-shaped device used for the surgical treatment of gastroesophageal reflux. This device appears on sonograms as a C-shaped, hypoechoic structure with nonspecific Doppler waveforms. Because the…
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