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Articles 
Katherine Samaras, Paul J. Kelly, Mathias N. Chiano, Tim D. Spector, and Lesley V. Campbell Current physical activity predicted lower total-body and central abdominal adiposity in healthy middle-aged female identical twins. After adjustment for genetic and environmental factors, the influence of physical activity was greater than that of other measured environmental factors.
Jesper Lagergren, Reinhold Bergström, and Olof Nyrén The association between body mass index and esophageal carcinoma was strong and was not explained by bias or confounding. The carcinogenic mechanism, however, remains to be clarified. The increasing prevalence of obesity in western countries could be important in understanding the increasing occurrence of this tumor.
Richard W. Light, Jeffrey T. Rogers, Dong-sheng Cheng, R. Michael Rodriguez Cardiovascular Surgery Associates, PC* Large pleural effusions may develop in a small proportion of patients after coronary artery bypass grafting. Most bloody effusions can be managed with one to three therapeutic thoracenteses. Resolution of nonbloody effusions may require anti-inflammatory agents, tube thoracostomy, or intrapleural injection of antisclerosing agents.
Robert R. Recker, K. Michael Davies, Rachel M. Dowd, and Robert P. Heaney In elderly women, continuous low-dose hormone replacement therapy with conjugated equine estrogen and oral medroxyprogesterone combined with adequate calcium and vitamin D provides a bone-sparing effect that is similar or superior to that provided by other, higher-dose hormone replacement regimens.
Brief Communications
Naeem K. Tahirkheli and Philip R. Greipp A regimen of terbutaline and theophylline seems to be effective prophylaxis against the systemic capillary leak syndrome. In this series of eight patients, maintenance of therapeutic drug levels was associated with favorable results.
Reviews
Arthur J. Barsky and Jonathan F. Borus Functional somatic syndromes cause great suffering and disability and have substantial societal costs. The public needs to recognize the ubiquity of benign symptoms and self-limited syndromes and to appreciate the influence of psychosocial factors on the experience of illness. Clinicians, in turn, should continue to search for biological and physical causes of symptoms but also examine psychological and sociocultural factors.
Perspectives
Paul M. Ridker When considering the clinical utility of screening for a new marker of cardiovascular disease, physicians should determine whether a standardized and reproducible assay for the marker is available, whether a consistent series of prospective studies indicate that baseline elevations of the marker predict future risk, and whether assessment of the marker adds to the predictive value of other plasma-based risk factors.
NIH Conferences
Jeffrey I. Cohen, Philip A. Brunell, Stephen E. Straus, and Philip R. Krause This conference paper focuses on recent developments in the biology, clinical presentation, treatment, and prevention of varicella-zoster virus infections.
Editorials
Roland L. Weinsier If someone is genetically predisposed to be physically inactive, is he or she predestined to become obese? The article by Samaras and colleagues in this issue contributes to our understanding of this question by examining the relation of physical activity and dietary behaviors to adiposity while controlling for genetic influences.
On Being a Patient
Mary O'Flaherty Horn As the pace of change in medicine quickens, physicians who teach will bear a special responsibility to provide strong examples of empathy and professionalism to students and residents. After all, one day we may find ourselves on the other side of the bed rail.
Letters Epinephrine and Outcome after Cardiac Arrest
Bee Sting Dysphagia
Electronic Patient–Physician Communication
Venlaxafine-Associated Hepatitis
David Hamerman Ameliorating frailty is an important health care goal that has enormous societal implications. This article describes many of the clinical correlates of frailty and considers evidence for this condition's biological underpinnings.
Henry S. Perkins
Dennis J. Mazur
Yucel Balbay and Duncan Neuhauser
Allison Oler
Angelee Deodhar
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