Table of Contents

March 16, 1999; 130 (6)

Articles

  • The serum creatinine concentration is widely used as an index of renal function, but this measure is affected by factors other than the glomerular filtration rate (GFR). This study examined an equation to predict GFR from serum creatinine concentrations and other factors.

  • Weight cycling was highly prevalent in a large cohort of middle-aged women. Independent of attained relative body weight, the risk for cholecystectomy associated with weight cycling was substantial.

  • Etanercept can safely provide rapid, clinically significant, and sustained benefit in patients with active rheumatoid arthritis.

  • Beclomethasone had a larger mean effect than montelukast, but both drugs provided clinical benefit to patients with chronic asthma. This finding is consistent with the use of these agents as controller medications for chronic asthma.

  • The cost–utility of polysomnography instead of home study or no testing for the diagnosis of the obstructive sleep apnea syndrome compares favorably with that of other procedures for which society judges the added utility per dollar spent to be worthwhile.

Brief Communications

  • Patients who have had splenectomy may be at increased risk for pulmonary hypertension.

  • Hypericin, the active compound in St. John's wort, caused significant phototoxicity and had no antiretroviral activity in HIV-infected patients.

Academia and Clinic

  • This paper describes an approach for evaluating prognostic systems based on the accuracy and generalizability of the system's predictions.

Medicine and Public Issues

  • Low reimbursement may limit the adoption of screening flexible sigmoidoscopy with or without biopsy in primary care practices.

Editorials

  • In patients with asthma, the overall response rate to the gold standard treatment, corticosteroids, may be as low as 70%. Clearly, there is a need to identify treatments that are effective when corticosteroids are not. Malmstrom and colleagues' study in this issue contributes to other studies that have increased our understanding of the beneficial effects and safety of leukotriene receptor antagonists.

  • In this issue, Chervin and colleagues present a cost–utility analysis that evaluates the relative effectiveness of three diagnostic strategies for the obstructive sleep apnea syndrome. This analysis points the way to a more rigorous cost-based approach to assessment of the relative value of different diagnostic strategies.

On Being a Patient

Letters

Medical Writings: Book Notes

Currents

Book Listings

Medical Notices