Table of Contents

August 5, 2003; 139 (3)

Articles

  • After age 50, many aspects of male sexual function decline sharply with each additional decade of age. In this study, several modifiable health behaviors were associated with erectile function. Physical activity and leanness were associated with good erectile function, while smoking, alcohol consumption, and television viewing time were associated with poor erectile function.

  • In hypertensive patients without clinically evident vascular disease, losartan and atenolol were equally effective in reducing blood pressure, but losartan was more effective in preventing cardiovascular death and morbidity (predominantly from stroke).

  • Past treatment guidelines for sexually transmitted diseases (STDs) have recommended empirical co-treatment for chlamydia when patients are treated for gonorrhea. Co-infection with chlamydia is still frequent in STD clinic patients who receive treatment for gonorrhea. This finding supports continuing routine co-treatment for chlamydia.

  • Selective intestinal decontamination with norfloxacin partially reverses the hyperdynamic circulatory state in cirrhotic patients without harming splanchnic or renal blood flow.

Academia and Clinic

  • The cosyntropin stimulation test has been part of the standard evaluation of suspected primary or secondary adrenal insufficiency. The cosyntropin test performs well in patients with primary adrenal insufficiency, but its lower sensitivity in patients with secondary adrenal insufficiency necessitates use of tests involving stimulation of the hypothalamus if the pretest probability is sufficiently high.

Review

  • This review examines the thermogenic effect of thyroid hormone and how it affects some thyroid diseases, energy balance, and body weight.

NIH Conferences

  • This conference discusses renal syndromes in HIV-infected patients, including HIV-associated thrombotic microangiopathy, immune-mediated glomerulonephritides, and nephropathy. Other topics include management of HIV-infected patients with chronic kidney disease, pathologic features of HIV-associated nephropathy, and mechanisms of HIV-associated renal injury.

Editorial

  • Fewer medical students are choosing office practice–oriented careers in medicine. Medical information technology will greatly improve the efficiency of office practice and make it a more attractive career alternative. However, developing excellent office information systems and distributing them nationally will require very strong, sustained leadership from a diverse group of stakeholders. Improving the infrastructure of medical practice is one of the supreme challenges facing medicine.

On Being a Doctor

  • Somewhere along the line, we learn that a patient's chart should not be tampered with and to do so is a breach of medical ethics. But I once did, and I think it was the right thing to do.

  • I'm not really sure when I first noticed him, proudly sitting on his porch with a broad smile on his weathered face. It was a comforting, peaceful sight—he in his twisted metal chair next to a tattered recliner, greeting the passing world. Most mornings as I hurried down a forgotten hospital access road lined with resident and physician housing, I was blessed with his presence. Countless times I told myself to stop, but I never did.

Letters

Medical Writings: Book Notes

Ad Libitum

Book Listings

Medical Notices

Summaries for Patients