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Articles 
John B. Wong and Raymond S. Koff For histologically mild chronic hepatitis C, initial combination therapy compared with periodic liver biopsy should reduce the future risk for cirrhosis, prolong life, and be cost-effective.
John N. Galgiani, Antonino Catanzaro, Gretchen A. Cloud, Royce H. Johnson, Paul L. Williams, Laurence F. Mirels, Faris Nassar, Jon E. Lutz, David A. Stevens, P. Kay Sharkey, Vipul R. Singh, Robert A. Larsen, Kathy L. Delgado, Cynthia Flanigan, and Michael G. Rinaldi Neither fluconazole nor itraconazole showed statistically superior efficacy in nonmeningeal coccidioidomycosis, although there was a trend toward slightly greater efficacy with itraconazole.
Rebecca J. Beyth, Linda Quinn, and C. Seth Landefeld A multicomponent program of warfarin management reduced the frequency of major bleeding in older patients. These findings support the premise that efforts to reduce the likelihood of major bleeding will lead to safe and effective use of warfarin therapy in older patients.
Brief Communications
Ellen Marqusee, Carol B. Benson, Mary C. Frates, Peter M. Doubilet, P. Reed Larsen, Edmund S. Cibas, and Susan J. Mandel Ultrasonography altered clinical management for 63% of patients referred to a thyroid nodule clinic after abnormal results on thyroid physical examination. The results suggest that routine thyroid ultrasonography should be seriously considered for all patients with suspected thyroid nodules.
Peter Schenk, Christian Madl, Shahrzad Rezaie-Majd, Stephan Lehr, and Christian Müller Intravenous methylene blue improved hypoxemia and hyperdynamic circulation in patients with liver cirrhosis and severe hepatopulmonary syndrome.
Reviews
Alexis M. Fenton, Stephen C. Hammill, Robert F. Rea, Phillip A. Low, and Win-Kuang Shen Vasovagal syncope is a common, difficult to manage clinical syndrome. Advancements are being made in laboratory investigations of its triggering mechanisms. Randomized, controlled trials of pharmacologic and nonpharmacologic interventions are needed.
NIH Conferences
David T. Felson, Reva C. Lawrence, Marc C. Hochberg, Timothy McAlindon, Paul A. Dieppe, Marian A. Minor, Steven N. Blair, Brian M. Berman, James F. Fries, Morris Weinberger, Kate R. Lorig, Joshua J. Jacobs, and Victor Goldberg Part 2 of this two-part conference focuses on treatments for osteoarthritis, including oral medications, alternative therapies, biomedical approaches, and surgery.
Editorials
Michael B. Fallon In this issue, Schenk and colleagues provide new insight into the pathogenesis of vasodilation in liver disease and raise extremely important therapeutic issues.
On Being a Doctor
Michael K. Williams Only by temporarily shedding our emotional armor for dying patients and their families will physicians be able to regain the trust of our individual patients and the trust of society as a whole.
Letters Coenzyme Q10 and Congestive Heart Failure
Outcomes of Lyme Disease
Update in Hepatology
Segment Length and Risk for Neoplastic Progression in Patients with Barrett Esophagus
Calcific Constrictive Pericarditis
Physicians and Patient Spirituality
Intractable Terminal Suffering
Government and Medical Education
A Question of Ethics
Successful Treatment of Hepatitis C in Sickle-Cell Disease
Troglitazone-Associated Hepatotoxicity Treated Successfully with Steroids
Isolated Elevation of Alkaline Phosphatase Level Associated with Rosiglitazone
Anion Gap Acidosis Associated with Acetaminophen
Treatment of Myelodysplasia in a Patient with Active Rheumatoid Arthritis
Correction: Ethics of Placebo-Controlled Trials
Michael Berkwits Naming is generally an act of tremendous symbolic and practical significance, and there is no reason to think it any less so in medical science. The growth of trial names in recent years reflects important professional and proprietary trends in medicine that deserve our attention.
Helen K. Delichatsios
Donald R. Miller
Dennis J. Sullivan
Dwaine Rieves
Karen E. Hauer and Neil Winawer This Update reviews key literature relevant to the care of hospitalized patients. Topics covered include pulmonary medicine, cardiology, infectious diseases, and end-of-life care. | |||||||||||||||||||||||||||||||||||||||||||||||||||
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