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February 7, 2002 Vol. 346 No. 6
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Both central sleep apnea and obstructive sleep apnea are characterized by episodes of apnea and hypopnea during sleep. Many patients also have associated arrhythmias and therefore receive permanent atrial pacemakers. This study found that, in such patients, atrial overdrive pacing at a rate 15 beats per minute above the base-line rate resulted in a substantial reduction in the frequency of episodes of apnea and hypopnea.
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Salmonella enterica serotype choleraesuis is a cause of serious systemic infections. Data from a surveillance system in Taiwan document the rapid emergence of fluoroquinolone resistance in this serotype. The rate of resistance has reached 60 percent. Molecular typing indicates that the source of the resistant isolates is likely to be herds of swine raised for food.
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The clinical and histologic features of high-grade gliomas in children are not always useful prognostic indicators. This study investigated the prognostic usefulness of evaluating gliomas in children for the presence of p53, a protein involved in numerous aspects of the life and death of a cell. Children with tumors that contained many p53-positive cells had a much poorer outcome than children with tumors that contained few or no p53-positive cells.
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Pneumonia remains a common and potentially serious infection in children. This review summarizes the problems involved in making the diagnosis and establishing a cause and offers a practical guide to treatment. Decisions should be based first on the age of the child, then on clinical and epidemiologic considerations, and finally, on the findings on chest radiography.
A 59-year-old man with a history of a nonproductive cough and wheezing presents with increasing shortness of breath. His symptoms have not responded to treatment with bronchodilators and inhaled corticosteroids or to treatment for sinusitis and esophageal reflux, but they improve when he takes oral prednisone.
This issue of the Journal contains two articles on Oregon's Death with Dignity Act. In a Health Policy Report, Steinbrook provides an overview of the 1994 Oregon law legalizing physician-assisted suicide. He discusses the effects of the law on the care of terminally ill patients and the various legal challenges that have been made to the law. The most recent challenge is the directive issued by the attorney general of the United States, John Ashcroft.
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