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Volume 337:940-942 September 25, 1997 Number 13
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Clinical Problem-Solving — Where Did Good Old Clinical Diagnosis Go?

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 by Rozenman, Y.
To the Editor: In their recent Clinical Problem-Solving article (May 15 issue),1 Rozenman et al. suggest that the delayed diagnosis of endocarditis was the result of a failure to follow up on an appropriate initial diagnostic hypothesis that the patient had anemia due to iron deficiency. I challenge the appropriateness of the belief that iron deficiency is common in this setting. The anemia that occurs after bypass surgery is due to acute blood loss. Average adult iron stores of about 1 g are equivalent to four to five units of blood. The net operative blood loss is less than this . . . [Full Text of this Article]

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