Table of Contents

February 20, 2001; 134 (4)

Articles

  • In 50 patients who had developed at least mild mitral regurgitation or aortic regurgitation after exposure to fenfluramines, serial echocardiography showed that valvular regurgitation improved or remained stable in most patients after therapy was discontinued. Worsening of valvular regurgitation was uncommon.

  • The findings of this study suggest that after dexfenfluramine therapy is taken for 2 to 3 months and then discontinued, development or progression of any valvular regurgitation over the following year is unlikely. Echocardiographic evidence indicates that aortic regurgitation regresses in some previously treated patients.

  • Decision support based on guidelines was more effective in changing blood test–ordering behavior than was decision support based on initially displaying a limited number of tests. Guideline-driven decision support systems can reduce the number of laboratory tests ordered by primary care practitioners.

Brief Communications

  • According to the results of a telephone survey, nearly 5 million U.S. adults used prescription weight loss pills in 1996–1998. However, one quarter of users were not overweight, suggesting that weight loss pills may be inappropriately used, especially among women, white persons, and Hispanic persons.

  • Incidence of and death from coronary heart disease among office-holding world leaders has decreased over the past 30 years, possibly because of increased use of cardiac procedures. A coronary event in a world leader is unlikely to presage a change in government.

Review

  • The authors discuss the risk factors associated with acquisition of antibiotic-resistant bacterial infections and potential strategies for preventing antibiotic resistance in the intensive care unit.

Perspectives

  • Case reports and case series have been subject to some serious questioning, but they have their own valuable role in the progress of medical science.

NIH Conferences

  • This conference report summarizes advances in the genetics, biochemical diagnosis, localization, and management of pheochromocytoma and notes key questions that remain unanswered.

Editorials

  • The studies by Weissman and Mast and their colleagues in this issue clarify two important issues concerning anorexogen-induced valvulopathy: that progressive valvulopathy is uncommon and that valvular regurgitation may spontaneously resolve in some patients after cessation of anorexogen therapy.

  • Girardi and colleagues' report in this issue suggests that most world leaders remain in power after a coronary event. In the United States, a president's physician, along with a White House physician and consultants, decides whether the president is disabled.

Letters

Medical Writings: Book Notes

Current Clinical Issues

Ad Libitum

Book Listings

Medical Notices

Summaries for Patients

Updates from the Annual Session

  • This Update focuses on topics in allergy and immunology that are particularly relevant to internal medicine: latex allergy, trimethoprim–sulfamethoxazole allergy, environmental controls for persons with allergies, food allergy, use of inhaled corticosteroids, use of monoclonal anti-IgE antibody, asthma, and allergic rhinitis.