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Articles 
Alka M. Kanaya, David Herrington, Eric Vittinghoff, Feng Lin, Deborah Grady, Vera Bittner, Jane A. Cauley, and Elizabeth Barrett-Connor In women with coronary disease, hormone therapy reduced the incidence of diabetes by 35%. Although this observation provides important insights into the metabolic effects of postmenopausal hormones, reducing the risk for diabetes is not a sufficient rationale to recommend the use of hormones for secondary prevention of heart disease.
Agha W. Haider, Martin G. Larson, Stanley S. Franklin, and Daniel Levy Although each component of blood pressure was associated with risk for congestive heart failure, pulse pressure and systolic pressure conferred greater risk than diastolic pressure. Increased pulse pressure may help identify hypertensive patients who, because they are at high risk for congestive heart failure, are candidates for aggressive blood pressure control.
Pasquale Strazzullo, Roberto Iacone, Licia Iacoviello, Ornella Russo, Gianvincenzo Barba, Paola Russo, Andria D'Orazio, Antonio Barbato, Francesco Paolo Cappuccio, Eduardo Farinaro, and Alfonso Siani The angiotensin-converting enzyme I/D polymorphism was a significant predictor of overweight and abdominal adiposity in men. DD homozygosity was associated with larger age-related increases in body weight and blood pressure, as well as with higher incidence of overweight and abdominal adiposity.
Anna Peeters, Jan J. Barendregt, Frans Willekens, Johan P. Mackenbach, Abdullah Al Mamun, Luc Bonneux for NEDCOM, the Netherlands Epidemiology and Demography Compression of Morbidity Research Group* Obesity and overweight in adulthood are associated with large decreases in life expectancy and increases in early mortality, similar to the decreases seen with smoking. Obesity in adulthood is a powerful predictor of death in middle age. Because of the increasing prevalence of obesity, more efficient prevention and treatment should become high priorities in public health.
Academia and Clinic
Patrick M. Bossuyt, Johannes B. Reitsma, David E. Bruns, Constantine A. Gatsonis, Paul P. Glasziou, Les M. Irwig, David Moher, Drummond Rennie, Henrica C.W. de Vet, and Jeroen G. Lijmer
Paul D. Cleary Patients are the best source of information about a hospital system's communication, education, and pain-management processes, and they are the only source of information about whether they were treated with dignity and respect. This article, part of the Quality Grand Rounds series, discusses relatively easy and inexpensive ways to avoid some consequences of a hospital's organizational problems.
Patrick M. Bossuyt, Johannes B. Reitsma, David E. Bruns, Constantine A. Gatsonis, Paul P. Glasziou, Les M. Irwig, Jeroen G. Lijmer, David Moher, Drummond Rennie, Henrica C.W. de Vet for the STARD Group* The STARD (Standards for Reporting of Diagnostic Accuracy) initiative provides carefully developed consensus-based guidelines for reporting of studies of diagnostic accuracy, enabling readers to better understand the design of the study and to assess the validity and applicability of the results.
Reviews
Christine Seibert, Ellen Barbouche, Julie Fagan, Erane Myint, Tosha Wetterneck, and Melaura Wittemyer This case-based paper discusses combined oral contraceptives in women older than 35 years of age, including potential risks and benefits, pretreatment assessment, common side effects and their management, appropriate follow-up, and diagnosis of menopause.
Perspectives
Niteesh K. Choudhry, Sujit Choudhry, and Peter A. Singer Patients who are reluctant to undergo cardiopulmonary resuscitation should be offered the option of consenting to cardiopulmonary resuscitation for "higher-success" situations, including a witnessed cardiopulmonary arrest in which the initial cardiac rhythm is ventricular tachycardia or fibrillation, cardiac arrest in the operating room, or cardiac arrest resulting from a readily identifiable iatrogenic cause. This new level of resuscitation could be called a "limited aggressive therapy" order.
Editorials
Peter W.F. Wilson In this issue, Kanaya and colleagues report a lower risk for new-onset type 2 diabetes in postmenopausal women receiving combined estrogen–progestin hormone replacement therapy. These results from the Heart and Estrogen/progestin Replacement Study are not definitive and require confirmation in a formalized clinical trial with predetermined hyperglycemic end points.
On Being a Doctor
Georganna Davis My preceptor had been my family physician since I was in kindergarten. This was the man who urged me every time I visited to come back to our rural town and take his place. I heard a distinctive, familiar voice call my name. "Miss Davis, are you ready to see what medicine is all about?"
On Being a Patient
June Bingham Having just emerged, age 82, from the Valley of the Shadow, thanks to a just-in-time-ly removal of a cancerous uterus, I am full of bright shiny ideas, most of which are probably worthless. But one, I'm convinced, is not. That is the need to expurgate the word "complaint" from the medical lexicon for defining reportage by elderly and other patients about their symptoms.
Letters Resident Stress
Alcohol and Congestive Heart Failure
Risk for Venous Thromboembolism in Carriers of the Factor V Leiden Mutation
Survival in Academy Award–Winning Actors and Actresses
J-Shaped Relationship in Hypertension
Contamination of the Blood Supply in the 1980s and 1990s
Hematopoietic Stem-Cell Transplantation for the Bernard–Soulier Syndrome
Correction: The Risk–Benefit Profile of Commonly Used Herbal Therapies
Gregory A. Plotnikoff
Ralph K. Della Ratta
George N. Braman
Norton J. Greenberger This Update discusses gastroesophageal reflux disease, Helicobacter pylori infection, infectious diarrhea, colon cancer screening, gastrointestinal bleeding, and inflammatory bowel disease. | |||||||||||||||||||||||||||||||||||||||||||||||||||
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