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In this Journal feature, information about a real patient is presented in stages (boldface type) to an expert clinician, who responds to the information, sharing his or her reasoning with the reader (regular type). The authors' commentary follows.
A 52-year-old woman who had undergone renal transplantation 13 years earlier was brought by her family to the emergency department of a community hospital. Five days earlier, she had suddenly begun to have tingling and numbness of her arms and she noted that the words on her computer screen appeared "mixed up." Her condition improved during the next 24 hours, but difficulty
Commentary
Source Information
From the Faculty of Medicine, University of Toronto (M.E.D., L.C., M.R.S., M.E.S., M.R.U.); the Department of Medicine, St. Michael's Hospital (L.C., M.E.S., M.R.U.); and the Department of Medicine, Mount Sinai Hospital and University Health Network (M.R.S.) all in Toronto.
Address reprint requests to Mr. Detsky, c/o Dr. Maureen Shandling, Mount Sinai Hospital, Rm. 429, 600 University Ave., Toronto, ON M5G 1X5, Canada, or at michael.detsky@utoronto.ca.
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