Table of Contents

April 16, 2002; 136 (8)

Articles

  • According to U.S. data collected from 1988 through 1995, a gap exists between recommended diabetes care and the care patients actually receive. These data offer a benchmark for monitoring changes in diabetes care.

  • Persons at high risk for diabetes mellitus are better identified by using a simple prediction model than by relying exclusively on the results of a 2-hour oral glucose tolerance test. Although adding the 2-hour glucose variable to the model enhanced prediction, the resulting slight improvement entails greater cost and inconvenience.

  • Persons who develop hypertriglyceridemia during isotretinoin therapy for acne, as well as their parents, are at increased risk for future hyperlipidemia and the metabolic syndrome.

Brief Communications

  • Seven patients developed acute hepatotoxicity within 3 months of using LipoKinetix, a weight loss supplement. Despite extensive evaluations, no other cause for hepatotoxicity could be identified in these patients.

Academia and Clinic

  • Physicians are increasingly grappling with medical liability issues as complementary and integrative health care practices are made available in conventional medical settings. This article proposes a framework in which physicians can assess potential malpractice liability issues in counseling patients about complementary and integrative therapies.

Review

  • Certain renal diseases seen in clinical practice have a rapid course that soon causes irreversible end-stage renal failure caused by complete structural damage. These diseases, however, are rare. The more common nephropathies progress more slowly but still evolve to end-stage renal failure. A multimodal approach that centers on reducing or removing all risk factors associated with renal disease progression may decrease the time to remission for most patients with proteinuric nephropathies.

Clinical Guidelines

  • The Hematology Disease Site Group of the Cancer Care Ontario Practice Guidelines Initiative has systematically reviewed the published literature and, through a consensus process, developed an evidence-based practice guideline assessing the role of stem-cell transplantation in patients with multiple myeloma. This paper discusses the six recommendations contained in the guideline.

Editorial

  • In this issue, Favreau and colleagues report on cases of hepatotoxicity in users of the dietary supplement LipoKinetix. This and other recent reports of adverse outcomes associated with supplement use highlight two important issues that merit further consideration: 1) regulation and safety of dietary supplements and 2) safety surveillance.

Letters

Medical Writings: Book Notes

Current Clinical Issues

Book Listings

Medical Notices

Summaries for Patients