Table of Contents

May 15, 2001; 134 (10)

Articles

  • In older patients with coronary heart disease and average or moderately elevated cholesterol levels, pravastatin therapy reduced the risk for all major cardiovascular events and all-cause mortality. Since older patients are at higher risk than younger patients for these events, the absolute benefit of treatment is significantly greater in older patients.

  • In six large case–control studies, the M235T and T174M angiotensinogen mutations were not consistently associated with increased (or decreased) risk for ischemic heart disease, myocardial infarction, or ischemic cerebrovascular disease. Statistically significant associations may represent chance findings rather than real phenomena.

  • The association of high status with increased longevity that prevails in the public also extends to celebrities, contributes to a large survival advantage, and is partially explained by factors related to success.

Brief Communications

  • Postoperative interferon-α therapy appears to decrease recurrence of cancer after resection of hepatitis C virus–related hepatocellular carcinoma.

Academia and Clinic

  • This study examined the relationship between a composite score of three measures of drug adherence and HIV virologic response. The authors found that different measures applied to the same patient suggest different levels of adherence. Adherence may be underestimated by an electronic measurement device and may be overestimated by pill count and interview. A summary measure is more strongly related to a clinical response, but more practical measurement methods are needed for clinical use.

Review

  • This paper, the second of two reviewing the role of host factors in HIV infection, discusses the role of genetic host factors—inheritance of mutant chemokine receptors or ligands as well as HLA type—in susceptibility to infection with HIV and subsequent clinical course. The effects of soluble inhibitory factors, the cytokine milieu, and concomitant infections are also described.

Perspectives

  • The instability of today's medical marketplace makes the future of general internal medicine uncertain. To thrive, general internal medicine must build on its strengths within the medical marketplace, seize the opportunities offered by demographic changes, and take a primary role in serving the needs of older patients with chronic diseases.

Editorials

  • Accumulating evidence suggests that social status itself, regardless of associated material and economic advantages, may confer health benefits. In this issue, Redelmeier and Singh provide further intriguing evidence by showing that actors and actresses who win Academy Awards live an average of 3.9 years longer than comparable performers who were nominated for an award but did not win.

  • Liu and colleagues' article in this issue contributes to the field of adherence measurement by showing improved predictive validity after incorporation of data from several adherence measures when data from an electronic monitor were missing. At this point, patient interview remains the most practical approach for clinicians, while a combination of adherence measures seems to be optimal for research purposes.

Letters

Medical Writings: Book Notes

Current Clinical Issues

Book Listings

Medical Notices

Summaries for Patients