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Articles
Victor J. Stevens, Eva Obarzanek, Nancy R. Cook, I-Min Lee, Lawrence J. Appel, Delia Smith West, N. Carole Milas, Mildred Mattfeldt-Beman, Lorna Belden, Charlotte Bragg, Marian Millstone, James Raczynski, Amy Brewer, Bali Singh, Jerome Cohen for the Trials of Hypertension Prevention Research Group Even modest weight loss can lead to clinically significant long-term reductions in blood pressure and reduced risk for hypertension.
Timo A. Lakka, Jari A. Laukkanen, Rainer Rauramaa, Riitta Salonen, Hanna-Maaria Lakka, George A. Kaplan, and Jukka T. Salonen Good cardiorespiratory fitness is associated with slower progression of early atherosclerosis in middle-aged men. These findings are important because they emphasize that middle-aged men can be evaluated for cardiorespiratory fitness to estimate their future risk for atherosclerotic vascular diseases.
Markus Schwerzmann, Christian Seiler, Ernst Lipp, Raphael Guzman, Karl O. Lövblad, Martin Kraus, and Nils Kucher In divers, the significance of a patent foramen ovale and its potential relation to paradoxical gas emboli remain uncertain. This study found that regardless of whether a diver has a patent foramen ovale, diving is associated with ischemic brain lesions.
Brief Communications
Eric S. Daar, Susan Little, Jacqui Pitt, Joanne Santangelo, Pauline Ho, Nina Harawa, Peter Kerndt, Janis V. Giorgi, Jiexin Bai, Paula Gaut, Douglas D. Richman, Susan Mandel, Stephen Nichols for the Los Angeles County Primary HIV Infection Recruitment Network* No sign or symptom was found to allow targeted screening for primary HIV infection. Although assays for HIV RNA are more sensitive than those for p24 antigen in diagnosing primary infection, they are more expensive and are more likely to yield false-positive results.
Academia and Clinic
Allan H. Goroll, Gail Morrison, Eric B. Bass, Robert Jablonover, Dionne Blackman, Roger Platt, Alison Whelan, and Francine P. Hekelman The Society of General Internal Medicine and the Clerkship Directors in Internal Medicine constructed a new curriculum for the internal medicine core clerkship. This reform effort has led to a new consensus on the structure and content of the core clerkship in internal medicine, one that refocuses attention on learning basic generalist competencies and moves a substantial proportion of training into the outpatient setting.
Reviews
Akhil A. Parulkar, Merri L. Pendergrass, Ramona Granda-Ayala, Tri Richard Lee, and Vivian A. Fonseca The authors discuss the nonhypoglycemic effects of the thiazolidinediones, with an emphasis on the potential of these drugs to improve other components of the insulin resistance syndrome, such as dyslipidemia, hypertension, and impaired fibrinolysis. They also describe the thiazolidinediones' effects in other insulin-resistant states, such as the polycystic ovary syndrome; examine their effects on body weight and composition; and draw attention to other potential effects currently being investigated.
Editorials
Thomas G. Pickering As highlighted in Stevens and colleagues' article in this issue, there is no simple solution to the problem of obesity. Dealing with it will require action at several levels: policy, education (of both the public and heath care providers), and incorporation of a team approach to patient care that involves dietitians and health educators.
Timothy Flanigan and Karen T. Tashima The article by Daar and colleagues in this issue is an important contribution regarding appropriate testing for acute or "primary" HIV infection. Primary care physicians should immediately begin to integrate routine screening for HIV infection so that individual patients and communities may benefit as soon as possible.
Frank Davidoff Electronic journals may or may not replace print versions in the lives of readers, but electronic systems have already proven invaluable in moving information back and forth, tracking it, retrieving it, and helping to do all the other intricate editorial housekeeping that's essential in creating a journalnot bad for a technology that's really just getting started.
Letters Hormone Therapy and Risk for Venous Thromboembolism: Comments and Correction
Sex Differences in HIV-1 Viral Load Due to Sex Difference in CCR5 Expression
Rita Charon Narrative medicine is medicine practiced with the narrative competence to recognize, interpret, and be moved to action by the predicaments of others. Examining medicine's practice of narrative writing may help us to understand its significance, its consequences, and the means to participate in it responsibly.
Sandra L. Bertman
Roy C. Ziegelstein
Bhuvana Chandra
Geraldine P. Schechter, Harish P.G. Dave, and Barbara M. Alving The hematology topics that generated the most attention in the past year were the newer concepts in anticoagulation, thrombosis, hemostasis, transfusion therapy, hemochromatosis, and novel therapies for hematologic malignancy.
Ira D. Glick, Trisha Suppes, Charles DeBattista, Rona J. Hu, and Stephen Marder This paper presents an updated synopsis for three major psychiatric illnesses: major depression, bipolar disorder, and schizophrenia. Current definitions, updated diagnostic criteria, short- and long-term treatment strategies with algorithms, and special challenges for the clinician are discussed for each of these illnesses. | |||||||||||||||||||||||||||||||||||||||||||||||||