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Articles 
Andrew T. Chan, Edward L. Giovannucci, Eva S. Schernhammer, Graham A. Colditz, David J. Hunter, Walter C. Willett, and Charles S. Fuchs Taking aspirin regularly is associated with a reduced risk for colorectal adenoma. The greatest effect occurred at substantially higher doses than those recommended for prevention of cardiovascular disease. Before recommending aspirin chemoprevention for all adults, we must understand the risks and benefits of routine aspirin use at these higher doses.
Jing Chen, Paul Muntner, L. Lee Hamm, Daniel W. Jones, Vecihi Batuman, Vivian Fonseca, Paul K. Whelton, and Jiang He The metabolic syndrome is defined as 3 or more of the following: hypertension, hyperglycemia, low high-density lipoprotein cholesterol levels, high triglyceride level, and abdominal obesity. The greater the number of these factors, the greater a person's risk for microalbuminuria and chronic kidney disease.
Daniel J. Quinlan, Andrew McQuillan, and John W. Eikelboom Fixed-dose low-molecular-weight heparin appears to be as effective and safe as dose-adjusted intravenous unfractionated heparin for the initial treatment of pulmonary embolism. This conclusion does not necessarily apply to patients with massive pulmonary embolism because the trials excluded them.
Brief Communications
Jennifer S. Haas, Celia P. Kaplan, Eric P. Gerstenberger, and Karla Kerlikowske According to this study, more public media attention is associated with greater adoption of clinical research results. The release of the Women's Health Initiative trial results was associated with a greater decline in postmenopausal hormone therapy use than occurred after publication of the Heart and Estrogen/progestin Replacement Study results, which received much less attention from newspapers and television.
Academia and Clinic
Penny Whiting, Anne W.S. Rutjes, Johannes B. Reitsma, Afina S. Glas, Patrick M.M. Bossuyt, and Jos Kleijnen Many factors in measuring the sensitivity and specificity of diagnostic tests can lead to biased estimates or variation between studies. Empirical evidence about the size and effect of these issues is limited.
Reviews
Andrea A. Howard, Julia H. Arnsten, and Marc N. Gourevitch Moderate alcohol consumption is associated with a decreased risk for developing diabetes mellitus and a decreased risk for heart disease in persons with diabetes. The long-term effects of alcohol consumption on glycemic control and noncardiac complications in persons with diabetes are poorly understood.
Perspectives
Carol Levine, Ruth Faden, Christine Grady, Dale Hammerschmidt, Lisa Eckenwiler, Jeremy Sugarman on behalf of the Consortium to Examine Clinical Research Ethics Existing laws and regulations protect research participants. However, some research protocols need additional "special scrutiny" because they create unusual ethical problems. The aim of special scrutiny is full protection for all research participants.
Editorials
Robert S. Sandler The concept of cancer chemoprevention is tantalizing. If we had a cheap, nontoxic pill that could reduce the risk for cancer, we might reduce the need for surgery or toxic chemotherapy. In this issue, Chan and colleagues provide additional evidence that we may already have such an agent for colorectal cancer. Its identity? Aspirin.
Lisa M. Schwartz and Steven Woloshin Over half of U.S. adults report that they follow health news closely. Thus, the press is well positioned to educate the public about health and health risks and what medicine can (and cannot) do. Researchers and medical journals have an obligation to help the media do their job responsibly.
On Being a Doctor
Cecil G. Helman They sit across the desk from me, the young couple, both tense and distracted. I am very new to family practice, and John is almost exactly the same age as I am. We are the same height and shape, and we have the same style of moustache. We are even dressed in a similar way. But there's a pinched, sallow look about his face, as if the mirror I am peering into is blurred and slightly dusty.
Letters Eponyms and the Diagnosis of Aortic Regurgitation
Adverse Events following Discharge from the Hospital
Reversible Tricuspid Stenosis Secondary to Massive Ascites in Hepatic Cirrhosis
J. M. García-Pinilla, J. J. Gómez-Doblas, I. Rodríguez-Bailón, R. Alcantara, M. F. Jiménez-Navarro, and E. De Teresa Mass Media–Induced Availability Bias in the Clinical Suspicion of West Nile Fever
Robert Badgett
John F. Fisher
Craig L. Bowron
Elliot Rapaport This Update focuses on heart failure, acute coronary syndromes, hypertension, and lowering of low-density lipoprotein cholesterol levels. The newer clinical trials in these fields are changing approaches to cardiac care. | |||||||||||||||||||||||||||||||||||||||||||||||||||
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