Table of Contents

June 20, 2000; 132 (12)

Articles

  • In an analysis biased against use of sildenafil, the cost-effectiveness of sildenafil treatment for erectile dysfunction compared favorably with that of accepted therapies for other medical conditions.

  • On-line tutorials for physicians may improve learning efficiency and satisfaction more than print materials do, but one self-study exposure may be insufficient for long-term knowledge retention.

  • The presence of lung inflammation identified patients with scleroderma who are more likely to have worsening lung function. Survival and lung function outcomes are improved in patients with alveolitis who receive cyclophosphamide.

Brief Communications

  • Elderly patients who were selected for participation in a trial of percutaneous coronary intervention had substantial improvements in health-related quality of life after this intervention that were similar to improvements in younger patients.

  • Hemophilic, HIV-positive patients with past or current hepatitis G virus infection had higher CD4+ lymphocyte counts and better AIDS-free survival rates. The mechanism of this association is unknown.

Academia and Clinic

  • Cost-utility analysis is an active and evolving field, but more consistency and clarity in reporting are needed. Better peer review and independent, third-party audits may help in this regard.

Review

  • This article reviews the definitions and scope of infertility, the interventions used for treatment of infertility, the medical complications of these interventions, the potential risks of fertility treatment in women unable to conceive spontaneously, and important issues for preconception counseling.

Abroad

  • Mild to moderate diarrheal disease continued to occur throughout Peace Corps service but decreased in incidence as length of stay increased. Various dietary behaviors increased the risk for diarrheal illness, suggesting that avoidance of potentially risky foods and beverages is actually beneficial.

Perspectives

  • The polycystic ovary syndrome (PCOS) is known to be associated with reproductive morbidity and increased risk for endometrial cancer. Diagnosis is especially important because PCOS is now thought to increase metabolic and cardiovascular risks.

Editorials

  • Smith and colleagues' cost-effectiveness analysis of sildenafil (Viagra) raises a fundamental and challenging issue associated with this therapeutic advance: Should health insurance pay for the treatment of erectile dysfunction at all?

  • It is unacceptable in this “information age” for medical information to remain in its current neglected and disorderly state. The concept of the informationist—a professional who will retrieve, synthesize, and present medical information—is an idea whose time has come.

On Being a Doctor

  • I had no interest in science whatsoever until my junior year in high school, when I met Dr. Elizabeth Helly. She appeared to have but two interests: her students and mathematics.

On Being a Patient

  • I was at the time a college student in Boston. Abortion was illegal. “Potassium permanganate can induce a spontaneous abortion. It is,” my chemistry lab partner whispered, “an abortifacient.“

Letters

Medical Writings: Book Notes

Currents

Ad Libitum

Book Listings

Medical Notices

Summaries for Patients