J Natl Med Assoc
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Review Case Reports
Hypercalcemia associated with adult T-cell leukemia/lymphoma (ATL).
Hypercalcemia is a frequent manifestation of human T-cell lymphotrophic virus type I (HTLV-I)-associated adult T-cell leukemia/lymphoma (ATL). Human T-cell lymphotrophic virus type I infection is endemic in the Caribbean, Japan, Melanesia, and Africa. This article presents two cases of ATL to increase awareness of the disease by primary care physicians. The management of hypercalcemia is discussed.
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A retrospective review was conducted to evaluate the influence of risk factors for human immunodeficiency virus (HIV) infection on the outcome of patients with end-stage renal disease (ESRD). The records of all patients seen at Howard University Hospital between February 1984 and July 1994 with a diagnosis of HIV infection were reviewed. ⋯ Risk factors for HIV infection in these patients were intravenous drug abuse, homosexual behavior, bisexual preference, and blood transfusion. None of these factors consistently influenced the survival of HIV-infected patients with ESRD.
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It has been well documented that early detection and early intervention for breast and cervical cancer saves lives. However, the challenge is to ensure that physicians' practices are effective in implementing the standard guidelines for screening and that all women are screened and undergo appropriate follow-up. ⋯ Studies also show that women are more likely to have mammograms if their physicians so advise. However, the most common reason women give for not obtaining mammograms is, "My doctor never recommended it." By using a simple critical path analysis tool to systematically evaluate an office practice and by implementing practical, simple principles, a physician can increase utilization of breast and cervical cancer screening.