Table of Contents

November 6, 2001; 135 (9)

Articles

  • Hepatitis B e antigen cleared in more than 70% of 1536 Alaska Native patients positive for hepatitis B surface antigen during the first 10 years of follow-up.

  • In patients undergoing colorectal cancer screening, aspirin use should not be based on potential chemoprevention. Aspirin chemoprophylaxis alone cannot be considered a substitute for colorectal cancer screening. Public policy should focus on improving screening adherence, even in patients who are already taking aspirin.

  • The CCR5-Δ 32 and CCR2-64I alleles had a strong protective effect on progression of HIV-1 infection, but SDF-1 3`A homozygosity carried no such protection.

Brief Communications

  • Universal vaccination in Taiwan significantly decreased the hepatitis B virus (HBV) carrier rate and infection rate among children and adolescents born since the program began in 1984. By decreasing the carrier pool, continuation of the national hepatitis B immunization program should prevent HBV infection in the children of Taiwan and, subsequently, adults as well.

Reviews

  • This review of myocardial infarctions that escape clinical recognition focuses on the prevalence, predisposing factors, and prognosis, and incorporates data from relevant epidemiologic studies, basic science investigations, and review articles.

  • Because congenital ventricular septal defects are of different sizes and locations, their clinical presentation, natural history, and treatment vary greatly. This review discusses the different types of ventricular septal defects commonly seen in adults.

Perspectives

  • Medicine has traditionally focused on relieving patient symptoms. However, in developed countries, maintaining good health increasingly involves management of such problems as hypertension, dyslipidemia, and diabetes, which often have no symptoms. Limitations in managing such problems are often due to clinical inertia—failure of health care providers to initiate or intensify therapy when indicated.

Editorial

  • As suggested by the papers by McMahon and Ni and coworkers in this issue, expanding the cohorts of children immunized as infants and decreasing the number of hepatitis B e antigen–positive persons will ensure that future generations are protected from hepatitis B virus infection and its consequences. However, without a nationwide program to vaccinate adults at increased risk for this infection, acute disease will continue to occur and transmission of hepatitis B virus will not be eliminated for decades.

On Being a Doctor

  • A physician muses on various aspects of modern clinical practice.

Letters

Medical Writings: Book Notes

Book Listings

Medical Notices

Summaries for Patients