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Articles 
Michael G. Shlipak, Paul A. Heidenreich, Haruko Noguchi, Glenn M. Chertow, Warren S. Browner, and Mark B. McClellan Renal insufficiency was an independent risk factor for death in elderly patients after myocardial infarction. Targeted interventions may be needed to improve treatment for this high-risk population.
R. Scott Wright, Guy S. Reeder, Charles A. Herzog, Robert C. Albright, Brent A. Williams, David L. Dvorak, Wayne L. Miller, Joseph G. Murphy, Stephen L. Kopecky, and Allan S. Jaffe Patients with renal failure are at increased risk for death after acute myocardial infarction and receive less aggressive treatment compared with patients who have normal renal function.
Anna Linda Zignego, Clodoveo Ferri, Francesca Giannelli, Carlo Giannini, Patrizio Caini, Monica Monti, Maria Eugenia Marrocchi, Elena Di Pietro, Giorgio La Villa, Giacomo Laffi, and Paolo Gentilini Patients with chronic hepatitis C and mixed cryoglobulinemia had increased frequency of bcl-2 rearrangement. The frequency was greatest in patients with type II mixed cryoglobulinemia. The high ratio of Bcl-2 to Bax in patients with bcl-2 rearrangement and the disappearance of the rearrangement with antiviral therapy suggest that the translocation is associated with the antiapoptotic function of Bcl-2 and that hepatitis C is linked to inhibition of B-cell apoptosis.
Brief Communications
Paul S. Phillips, Richard H. Haas, Sergei Bannykh, Stephanie Hathaway, Nancy L. Gray, Bruce J. Kimura, Georgirene D. Vladutiu, John D.F. England the Scripps Mercy Clinical Research Center* Some patients who develop muscle symptoms while receiving statin therapy have demonstrable weakness and histopathologic findings of myopathy despite normal serum creatine kinase levels. These findings resolve after discontinuation of statin therapy and recur with resumption of therapy.
Academia and Clinic
Jeffrey G. Jarvik and Richard A. Deyo The authors review evidence on the diagnostic accuracy of clinical information and imaging for patients with low back pain in primary care settings.
Stephanie A. Mulherin and William C. Miller Spectrum bias is a term commonly used to describe the heterogeneity that occurs when diagnostic test performance varies across patient subgroups and a study of that test's performance does not adequately represent all subgroups. This paper proposes the use of the term spectrum effect rather than spectrum bias, and it outlines strategies for using stratified sensitivity and specificity estimates, likelihood ratios, and receiver-operating characteristic curves.
Reviews
Paula M. Calvert and Harold Frucht Understanding of the epidemiology and molecular genetics of colon cancer is rapidly advancing. With these advances come opportunities for clinically applicable genetic tests. These tests are not perfect and are still prone to false-positive and false-negative results. Thus, the clinical understanding of colon cancer remains the basis for management decisions, with genetic testing having a potentially important supporting role.
Perspectives
Edward J. Huth Joseph Russell Elkinton, the fourth editor of Annals of Internal Medicine, died on 6 April 2002. He was a diligent, valuable servant of the American College of Physicians–American Society of Internal Medicine and merits a clear place in its history.
Editorials
Raymond R. Townsend In this issue, Shlipak and Wright and colleagues address the role of impaired kidney function as a risk factor for myocardial infarction. Their findings suggest that clinicians underuse available treatments in patients presenting with acute myocardial infarction and impaired kidney function.
Scott M. Grundy Phillips and colleagues' report in this issue on low-grade myopathy associated with statin use in a few patients highlights the need for further study on the actions of statins on muscle metabolism and structure.
Letters Sequelae and Serologic Outcome in Persons with Hepatitis B Virus Infection
Risk Index for Postoperative Pneumonia
Extended Out-of-Hospital Low-Molecular-Weight Heparin for Prophylaxis against Deep Venous Thrombosis
Quality Indicators for Management of Osteoporosis
Automated External Defibrillators
Aspirin for the Primary Prevention of Cardiovascular Events
Caring for Patients at the End of Life
The Other Résumé
It's Only 50 Cents
Rapid Development of Massive Tendon Xanthomas following Highly Active Antiretroviral Therapy
Pneumonitis Associated with Nonsteroidal Antiandrogens: Presumptive Evidence of a Class Effect
Infliximab-Induced Systemic Lupus Erythematosus
Bioterrorism and Physicians
Correction: Articles on Diagnostic Tests
Lawrence J. Schneiderman What good is empathy? The closer we get to the feelings of our patients, goes the argument, the better we can understand them and the more likely we will be able to diagnose and treat correctly. This is what novels, stories, and other works of art are supposed to help us with. As a physician and writer I both believe and doubt this.
Jeffrey M. Levine
Lawrence Loo
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