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Articles 
Paul D. Stein, Russell D. Hull, Kalpesh C. Patel, Ronald E. Olson, William A. Ghali, Rollin Brant, Rita K. Biel, Vinay Bharadia, and Neeraj K. Kalra Excluding a diagnosis from consideration requires a test result that will reduce its probability to below a threshold. Among tests for D-dimer, enzyme-linked immunosorbent assays (ELISAs) had the highest sensitivity and lowest negative likelihood ratio, which makes ELISA the best D-dimer test for excluding deep venous thrombosis and pulmonary embolism.
Eunyoung Cho, Stephanie A. Smith-Warner, John Ritz, Piet A. van den Brandt, Graham A. Colditz, Aaron R. Folsom, Jo L. Freudenheim, Edward Giovannucci, R. Alexandra Goldbohm, Saxon Graham, Lars Holmberg, Dong-Hyun Kim, Nea Malila, Anthony B. Miller, Pirjo Pietinen, Thomas E. Rohan, Thomas A. Sellers, Frank E. Speizer, Walter C. Willett, Alicja Wolk, and David J. Hunter Alcohol intake, measured at one point in time, is associated with a modest relative elevation in colorectal cancer rate. This effect occurs mainly at the highest levels of alcohol intake.
Timothy H. Rainer, Paul K.S. Chan, Margaret Ip, Nelson Lee, David S. Hui, DeVilliers Smit, Alan Wu, Anil T. Ahuja, John S. Tam, Joseph J.Y. Sung, and Peter Cameron During an outbreak in Hong Kong, the authors searched for subclinical or mild forms of severe acute respiratory syndrome (SARS) coronavirus infection. They found no evidence for widespread occurrence of a mild form of SARS that would escape detection when patients present for clinical evaluation.
Reviews
David A. Grimes and Mitchell D. Creinin Focusing on early induced abortions, the authors describe the numbers and characteristics of women having abortions, review the methods used, summarize safety data, explain how internists can respond to patients' requests for referral to abortion providers, and describe costs.
Dennis J. Selkoe In the last several years, Alzheimer disease researchers have come to agree that certain biochemical changes in the hippocampus and association cortices occur many years or decades before clinical symptoms. We can now describe a rough outline of the cascade of events leading to disease.
Perspectives
Eric B. Larson the Society of General Internal Medicine (SGIM) Task Force on the Domain of General Internal Medicine* Today's chaotic health care scene gives general internal medicine an opportunity to innovate and move beyond its current state of confusion. The field must adapt to a new world of consumerism, rising public expectations, widespread information dissemination, and pressures to hold down costs at a time when the demand for services is increasing because more people are surviving to live with chronic disease in old age.
Clinical Guidelines
Vincenza Snow, Mark D. Aronson, E. Rodney Hornbake, Christel Mottur-Pilson, Kevin B. Weiss the Clinical Efficacy Assessment Subcommittee of the American College of Physicians* The American College of Physicians makes 4 recommendations for lipid control in patients with type 2 diabetes: 1) Use lipid-lowering therapy for secondary prevention of cardiovascular mortality and morbidity for all patients with known coronary artery disease and type 2 diabetes; 2) use a statin for primary prevention of macrovascular complications in patients with type 2 diabetes and other cardiovascular risk factors; 3) patients with type 2 diabetes who take statins should take at least moderate doses; 4) for patients with type 2 diabetes who are taking statins, routine monitoring of liver function tests or muscle enzymes is unnecessary except in specific circumstances.
Sandeep Vijan and Rodney A. Hayward In patients with type 2 diabetes, treatment with lipid-lowering agents reduces the risk for cardiovascular disease. Statins reduce cardiovascular disease risk in most patients, including those whose baseline low-density lipoprotein cholesterol levels are below 2.97 mmol/L (<115 mg/dL), and possibly below 2.59 mmol/L (<100 mg/dL). Most patients with diabetes should receive at least moderate doses of these drugs.
Editorials
The Editors We hope that the report by the Society of General Internal Medicine Task Force on the Domain of General Internal Medicine in this issue will spur conversations among internists and their colleagues, patients, and others with a vested interest in seeing health care safely through dangerous waters. To start those conversations, we have asked 5 individuals to respond to different aspects of the report.
Richard J. Baron I agree with the thrust of the Society of General Internal Medicine Task Force report, but it left out an essential feature of daily practice: We connect, interpret, personalize, and customize medical care.
Howard K. Rabinowitz The combined force of all generalists who care for adults (internists and family physicians) could collectively speak with a much more powerful voice to address the critical issues about the important role of primary care in the health care system.
Robert B. Copeland The Society of General Internal Medicine Task Force on the Domain of General Internal Medicine has reaffirmed that breadth and depth is the fundamental strength of internal medicine.
Gail R. Wilensky The Task Force's proposals for payment reform will fall on deaf ears if they increase the total costs of care. Evidence to the contrary is essential.
Holly J. Humphrey The Task Force recommends using residency training to prepare for the requirements of a specific practice: subspecialist or generalist, rural or urban, and predominantly outpatient or inpatient setting. I concur, but with reservations.
Letters Potentially Fatal Interaction between Diltiazem and Statins
Another Presentation of Gout
Mucinous Appendiceal Adenocarcinoma Presenting 5 Years after Appendectomy
Retrobulbar Optic Neuritis Associated with Infliximab in a Patient with Crohn Disease
Spinal Manipulation for Low Back Pain
Insulin Combination Therapy in Type 2 Diabetes Mellitus
Losartan for Microalbuminuria in Normotensive Type 2 Diabetes Mellitus
Computer Physician Order Entry
The Rise of Litigation in Human Subjects Research
Ezetimibe and Statin-Associated Myopathy
Richard Fux, Klaus Mörike, Udo-Frank Gundel, Rüdiger Hartmann, and Christoph H. Gleiter Remission of Hepatitis B Virus-Related Vasculitis with Lamivudine
Takuya Sawabe, Takeshi Uenotsuchi, Shinichi Imafuku, Hiroshi Kohno, Junichi Arima, and Takahiko Horiuchi Whipple Pancarditis as a Cause of Heart Failure
Organizational Changes in a Single Intensive Care Unit Affect Benchmarking
Leonard E. Braitman
Nancy J. Stiles
Jennifer Fisher Wilson
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