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Articles 
Shari S. Bassuk, Thomas A. Glass, and Lisa F. Berkman Social engagement, defined as the maintenance of many social connections and a high level of participation in social activities, has been thought to prevent cognitive decline in elderly persons. In a large group of noninstitutionalized elderly patients, social disengagement was found to be a risk factor for cognitive impairment.
Haruhiko Yoshida, Yasushi Shiratori, Mitsuhiko Moriyama, Yasuyuki Arakawa, Tatsuya Ide, Michio Sata, Osami Inoue, Michitami Yano, Motohiko Tanaka, Shigetoshi Fujiyama, Shuhei Nishiguchi, Tetsuo Kuroki, Fumio Imazeki, Osamu Yokosuka, Shingo Kinoyama, Gotaro Yamada, Masao Omata for the IHIT Study Group Among patients with chronic hepatitis C, interferon therapy significantly reduced the risk for hepatocellular carcinoma, especially in persons who showed a virologic or biochemical response.
Larissa Avilés-Santa, Joyce Sinding, and Philip Raskin The addition of metformin to insulin therapy resulted in hemoglobin A1c concentrations that were lower than those achieved by insulin therapy alone. This improvement in glycemic control occurred with the use of less insulin and without substantial weight gain.
Brief Communications
David S. Weinberg, Craig J. Newschaffer, and Allan Topham Previous endometrial or ovarian cancer, particularly when diagnosed at an early age, increases subsequent risk for colorectal cancer. Greater emphasis on colorectal cancer screening in these populations may be necessary.
Joel Tsevat, Susan N. Sherman, Judith A. McElwee, Karen L. Mandell, Loretta A. Simbartl, Frank A. Sonnenberg, and Floyd J. Fowler, Jr. Many patients with HIV have a strong will to live, and many feel that life with HIV is better than it was before they became infected.
Reviews
Stefan Faderl, Moshe Talpaz, Zeev Estrov, and Hagop M. Kantarjian Chronic myelogenous leukemia is one of the best-studied malignant conditions in humans. Progress in the understanding of molecular pathways has led to increasingly targeted and effective treatments, including allogeneic stem-cell transplantation and interferon-
Editorials
Mary N. Haan In this issue, Bassuk and colleagues report modest associations between social ties and cognitive decline in elderly persons. Decline in elderly persons is complex and multifactorial; at best, medical treatment of complicated cases merely ameliorates the problems. Bassuk and colleagues' findings suggest that in such cases, the simple act of caring may be enough to slow the long slide into dementia.
On Being a Doctor
Julia E. McMurray O.U. School of Medicine, class of 1945. My mother is one of only three women in the sepia-toned photograph. "How come you never worked as a doctor, Mama?" I asked frequently.
On Being a Patient
Alison S. Clay It is the first day of my surgery clerkship. After a frantic race to a patient in crisis, my shortness of breath blossoms into an exercise-induced asthma attack. Despite my assertions that I am fine, I soon find myself admitted to the hospital.
Letters Prediction Rule for Renal Artery Stenosis
Alternative Views on Alternative Medicine
John A. Balint In the past 12 years, four books have addressed the issues of the changing setting and nature of the patient–physician relationship. They have also tackled the even more difficult problem of defining the relationship and identifying its essential components. These books show the way to start on the road of educating young physicians to become caring physicians, but they do not have the final answers.
David H. Neustadt
Elliott M. Antman
John E. Billi and Jeanne M. Kin
Philip W. Smith
Diane Altkorn, Keith Roach, Scott Stern, and Wendy Levinson The 1999–2000 Update Series begins with a discussion of important studies relevant to general internal medicine. Among the subject areas covered are cancer, stroke, venous thromboembolism, and osteoporosis. | |||||||||||||||||||||||||||||||||||||||||||||
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