Table of Contents

August 15, 2000; 133 (4)

Articles

  • Use of zinc lozenges was associated with reduced duration and severity of cold symptoms, especially cough. Improvement in clinical symptoms with zinc treatment may be related to a decrease in proinflammatory cytokine levels; in this study, however, the observed changes in cytokine levels did not significantly differ between zinc and placebo groups.

  • The waiting period for elective procedures, such as coronary artery bypass grafting, may be used to enhance in-hospital and early-phase recovery, improving patients' functional abilities and quality of life while reducing their hospital stay.

  • Troglitazone therapy improved metabolic control and increased body fat in patients with lipoatrophic diabetes. The substantial benefits of troglitazone must be balanced against the risk for hepatotoxicity, which can occur relatively late in the treatment course.

Brief Communications

  • The efficacy of rituximab for immune-mediated thrombocytopenia in the patient described here suggests that this drug may have activity in other autoimmune diseases or chronic graft-versus-host disease.

  • Antiretroviral therapy reduces shedding of HIV in semen; in turn, this reduction probably decreases HIV transmissibility. However, a substantial proportion of patients may still be infectious and may harbor drug-resistant strains of the virus.

In the Balance

  • Given the progressive aging of the U.S. population, it may seem natural for geriatrics to become a separate specialty with its own academic department. The author recommends an alternative—a center on aging or pan-institutional program that is firmly anchored in the department of internal medicine.

  • The author argues the case for departments of geriatric medicine as institutional structures that can advance research, improve teaching, and enhance patient care.

Editorials

  • Prasad and colleagues' study in this issue points to an important, often overlooked issue in randomized, double-blind, placebo-controlled trials: testing the participants' assessment of whether they are receiving placebo or active drug.

  • In this issue, Arioglu and colleagues report that troglitazone led to better metabolic control and increased body fat in patients with lipoatrophic diabetes. What are the mechanisms of the efficacy of troglitazone in these patients?

Letters

Medical Writings: Book Notes

Current Clinical Issues

Ad Libitum

Book Listings

Medical Notices

Summaries for Patients

Updates from the Annual Session

  • Topics covered in this Update include antimicrobial resistance, community-acquired pneumonia, and HIV infection.