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Martha D. McDaniel, MD, Discussant

JAMA. 1998;279:615-621.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

INTRODUCTION

DR DALEY: Mrs D is a 52-year-old mother of 2 children who has progressive pain in her right leg while walking. She lives in Boston and has her health care insurance through Massachusetts Medicaid and Medicare.

Mrs D has had insulin-dependent diabetes mellitus for 29 years, complicated by peripheral neuropathy, retinopathy, and nephropathy with nephrotic range proteinuria. She has had 1 atrophic kidney since childhood and has required chronic hemodialysis since June 1997. She has had hypertension since age 16 years. The patient has long-standing coronary artery disease with a history of 2 myocardial infarctions. She had percutaneous transluminal angioplasty for chronic angina without relief, followed by coronary artery bypass graft for triple vessel disease, including significant stenosis of the left anterior descending artery, in June 1997. She had an episode of congestive heart failure in 1995 with an ejection fraction of 0.25. She has . . . [Full Text of this Article]

MRS D: HER UNDERSTANDINGS AND PERCEPTIONS

DR S: HER UNDERSTANDINGS AND PERCEPTIONS

AT THE CROSSROADS: QUESTIONS TO DR MCDANIEL

Intermittent Claudication: Definition and Differential Diagnosis

Natural History and Significance of Intermittent Claudication

Treatment Options for Intermittent Claudication

Medication

Exercise

Anatomic Intervention

Choosing Among Alternatives

Factors Influencing Prognosis in Intermittent Claudication

What Should Mrs D Do?

QUESTIONS AND DISCUSSION

Dr McDaniel is Associate Professor of Surgery, Dartmouth Medical School, and Acting Chief, Surgical Service, Veterans Affairs Medical Center, White River Junction, Vt.

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RELATED LETTER

Prominence of Patients' Insurance Status in Clinical Crossroads
Robert J. Amdur, Jennifer Daley, Richard A. Parker, Erin E. Hartman, and Thomas L. Delbanco
JAMA. 1998;280(13):1137-1138.
EXTRACT | FULL TEXT  

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A 52-Year-Old Woman With Diabetes and Claudication, 1 Year Later
Daley and Hartman
JAMA 1998;280:1439-1439.
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Prominence of Patients' Insurance Status in Clinical Crossroads
Amdur et al.
JAMA 1998;280:1137-1138.
FULL TEXT