Table of Contents

April 6, 1999; 130 (7)

Articles

  • Sociodemographic factors, such as region and education, may be more strongly associated with use of hormone replacement therapy than are clinical factors, such as risk for cardiovascular disease.

  • Dietary intake of ω-3 fatty acids modestly mitigates the course of coronary atherosclerosis in humans.

  • Depressive symptoms are associated with long-term mortality in older patients hospitalized with medical illnesses. This association is not fully explained by greater levels of comorbid illness, functional impairment, and cognitive impairment in patients with more symptoms of depression.

  • Increases in CD4 counts from very low levels to at least 200 cells/mm3 are associated with a reduced rate of disease progression. However, a previously low CD4 cell count nadir remains associated with a moderately high risk for disease progression among patients with CD4 cell counts of at least 200 cells/mm3.

Brief Communications

  • In healthy young adults, arterial endothelial dysfunction related to passive smoking seems to be partially reversible.

  • This report describes three patients with asystole or bradycardia associated with complex partial seizures and reviews the relevant literature.

Updates

  • This Update reviews the clinically relevant pharmacology of heroin and naloxone, the epidemiology of fatal and nonfatal heroin overdose, the clinical diagnosis of heroin overdose, appropriate treatment, complications, and prevention strategies.

NIH Conferences

  • The autoimmune lymphoproliferative syndrome is a recently defined illness that arises in early childhood and is associated with prominent nonmalignant lymphadenopathy, hepatosplenomegaly, and autoimmune manifestations. This syndrome affords novel insights into the mechanisms that regulate lymphocyte homeostasis and underlie the development of autoimmunity.

Editorials

  • The results of Keating and colleagues' study, reported in this issue, suggest that we may have many more questions to ask and answer about our female patients and how we collaborate with them to find out whether they should use hormone replacement therapy.

  • As highlighted by Steiner's paper in this issue, evidence-based medicine must grapple with the fact that in the individual patient, one of its pillars—probability—is ambiguous and elusive, no matter how we choose to communicate it.

  • The shortage of transplantable organs hits the African-American community disproportionately hard. What is responsible for this shortage, and what can be done about it?

On Being a Doctor

  • He greeted me as he always did, hands folded weakly together in the gesture of respect that is ubiquitous in India.

Letters

Medical Writings: Lingua Medica

  • As physicians, we need to become bilingual—we must speak the language of populations as well as the language of individual patients. If we are fluent in both languages, we remind ourselves that we offer our patients choices, not treatments, and we remind our patients that whatever their treatment choices, the outcomes of health care are uncertain.

Medical Writings: Book Notes

Ad Libitum

Book Listings

Medical Notices