Table of Contents

June 19, 2001; 134 (12)

Articles

  • The risk for malignant disease is increased in biopsy-proven dermatomyositis and polymyositis and also appears to be increased in inclusion-body myositis.

  • In responding to a survey, physicians formulated survival estimates for patients with cancer and indicated the survival estimates that they would communicate to their patients if the patients insisted. Physicians reported that even if patients with cancer requested survival estimates, they would provide a frank estimate only 37% of the time and would provide no estimate, a conscious overestimate, or a conscious underestimate most of the time (63%).

  • Consumption of fruits and vegetables, particularly green leafy vegetables and vitamin C–rich fruits and vegetables, appears to have a protective effect against coronary heart disease.

Brief Communications

  • In hypercholesterolemic men, diets low in fat (especially saturated fat) and diets rich in monounsaturated fats improve endothelial function.

  • In very sick hospitalized patients, performance on seven Piagetian tasks of judgment was similar to that among children younger than 10 years of age. This finding indicates the importance of further investigation of the reasoning of sick patients and their ability to make sound judgments about clinical decisions, informed consent, and the execution of legal documents.

Academia and Clinic

  • The term genetic anticipation is used when genetically transmitted disease manifests at increasingly younger ages with each succeeding generation: that is, if the offspring of patients develop the disease, they will tend to do so at an earlier age than their parents. According to this study among patients with Crohn disease, apparent genetic anticipation can be explained by observational biases without invoking any additional genetic influences.

Review

  • The authors review the current clinical experience and future trends in cardiac pacing in four specific areas: 1) hypertrophic cardiomyopathy, 2) dilated cardiomyopathy and heart failure, 3) neurocardiogenic syncope, and 4) the prevention of atrial fibrillation.

Editorials

  • Lamont and Christakis's study on estimating survival for patients with cancer, reported in this issue, deserves widespread attention and discussion. The prognostic information we communicate to patients should be vague enough to include the truth—“usually weeks or months”—and specific enough to help people plan their lives and deaths.

  • As I suspected when I started more than 6 years ago, editing Annals has been quite an adventure. It's taken me to the very heart of science and medicine. I wouldn't have missed a minute of it.

On Being a Doctor

  • Feeling the warmth of my son's voice or his broad, reassuring man's hand on my shoulder, I travel by reflex back half my lifetime and nearly all of his, returning to a night when his eyes wouldn't leave my face, when the links of love and comfort were forged in the resolute watchfulness of a father by his infant son, a nocturne of blue light and milk, the mysterious beginnings of love.

Letters

Medical Writings: Book Notes

Current Clinical Issues

Book Listings

Medical Notices

Summaries for Patients