Annals of internal medicine
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Political decisions may cause disease. During 1992 and 1993, an epidemic of neuropathy in Cuba--largely overlooked by U. S. physicians--affected more than 50,000 persons and caused optic neuropathy, deafness, myelopathy, and sensory neuropathy. ⋯ Physicians may need to use their influence to modify political decisions when these decisions result in adverse health consequences. The American Academy of Neurology has issued a plea to encourage physicians and other health personnel to support efforts leading to lifting of the U. S. embargo against Cuba for humanitarian reasons.
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Review Practice Guideline Guideline
Preventing firearm violence: a public health imperative. American College of Physicians.
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Secondary infections remain the leading cause of death in patients with the acquired immunodeficiency syndrome (AIDS). Dealing with the rapidly evolving spectrum of infectious problems seen in patients with AIDS requires knowledge of current therapeutic and prophylactic strategies. Through an extensive preclinical trials network supported by both industry and government, an increasing number of new agents are being identified and rapidly moved into clinical trials. ⋯ Mycobacterial infections, particularly with Mycobacterium tuberculosis, have become an increasing problem for patients with AIDS, and both old and new combination drug regimens are being used. Cytomegalovirus disease, until recently an untreatable problem, can now at least be partially managed with antiviral agents. The use of more complete prophylactic regimens may decrease the morbidity and mortality from opportunistic infections.
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To assess the clinical efficacy of magnetic resonance imaging (MRI) for neuroimaging and to provide guidelines for clinical practice. ⋯ Although suggestions for appropriate use of MRI in clinical practice can be made, the supporting evidence in published studies is weak. Firm guidelines for appropriate use of MRI should be based on further clinical research using more rigorous methods.
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To review the clinical use of noninvasive positive pressure ventilation, including its efficacy with acute and chronic forms of respiratory failure, its mechanism of action, and its implementation. ⋯ Noninvasive positive pressure ventilation is effective in the treatment of chronic respiratory failure due to restrictive thoracic diseases. The routine use of such treatment for chronic respiratory failure due to chronic obstructive pulmonary disease and for acute respiratory failure needs to be studied in randomized controlled trials in better-defined patient subsets.