Table of Contents

February 15, 2000; 132 (4)

Articles

  • This study found that infants with low birthweight were at increased risk for developing elements of the insulin resistance syndrome in adult life. This increase in risk was associated with mothers' low body mass index during pregnancy and seems independent of the offspring's high adult body mass index.

  • HFE gene testing for the C282Y mutation is a cost-effective method of screening relatives of patients with hereditary hemochromatosis.

  • Subclinical hypothyroidism is a strong indicator of risk for atherosclerosis and myocardial infarction in elderly women.

Brief Communications

  • Consumption of olestra can cause false-positive results on tests for steatorrhea and may therefore lead to an erroneous diagnosis of the malabsorption syndrome.

  • Hyperammonemia is a potentially fatal event occurring after orthotopic lung transplantation. It is associated with concurrent medical stressors, primary pulmonary hypertension, and hepatic glutamine synthetase deficiency.

Perspectives

  • Many clinicians who care for patients with HIV infection are dissatisfied with the existing recommendations for antiretroviral therapy. A more cautious, patient-focused, long-term approach to therapy would help foster studies of alternate strategies, such as delayed initiation of therapy, protease inhibitor–sparing therapy, and immune-based therapy.

History of Medicine

  • In the United States and Germany before World War II, physicians participated in state-authorized eugenic sterilization programs in an attempt to prevent persons deemed to possess undesirable heritable characteristics from propagating. A comparison of U.S. and German histories reveals similarities that argue against easy dismissal of a Nazi analogy.

NIH Conferences

  • Although the pathogenesis of liver injury caused by the hepatitis C virus (HCV) has not yet been defined, cell-mediated immune responses may be important. Chronic HCV infection is a major cause of cirrhosis, end-stage liver disease, and liver cancer. Therapy for HCV infection is still evolving, and although an HCV vaccine is not imminent, recent advances have engendered novel approaches to problems with vaccine development.

Editorial

  • In this issue, Henry argues the case for a more conservative, individualized approach to antiretroviral therapy and challenges some of the foundations on which guidelines have been built. Guidelines can provide useful suggestions, but decisions must be made jointly by the patient and physician after careful weighing of the risks and benefits and the patient's readiness to commit to a complex medical regimen.

On Being a Doctor

  • I knew who she was—an ASP, an Auditor for the Special Program. We had a different rendition of the acronym: A Spy Patient.

Letters

Medical Writings: Book Notes

Currents

Ad Libitum

Book Listings

Medical Notices

Summaries for Patients

Updates from the Annual Session

  • Among the topics covered in this Update are mechanical ventilation, sepsis and infection, and thromboembolism.