Table of Contents

August 20, 2002; 137 (4)

Articles

  • Vaccination is cost-beneficial in most influenza seasons in healthy working adults. Although the benefits of antiviral therapy for persons with influenza infection appear to justify its cost, head-to-head trials of the various antiviral therapies are needed to determine the optimal treatment strategy.

  • Evidence on ultrasonography of any halo or a halo 1 mm or greater in thickness around temporal arteries only modestly increased the probability of biopsy-proven giant-cell arteritis but did not improve the diagnostic accuracy of a careful physical examination.

  • Maintenance therapy against previous infection with cytomegalovirus, Mycobacterium avium complex, Toxoplasma gondii, or Cryptococcus neoformans in patients with HIV infection can be interrupted after sustained CD4 count increases to greater than 200 (or possibly 100 to 200) × 106 cells/L for at least 6 months after the start of potent antiretroviral therapy.

Brief Communications

  • Oral vitamin K lowers the international normalized ratio more rapidly than subcutaneous vitamin K in asymptomatic patients who had supratherapeutic international normalized ratio values while receiving warfarin.

Academia and Clinic

  • Effective clinical management of sexually transmitted diseases is a strategic common element in efforts to prevent HIV infection and to improve reproductive and sexual health. This paper presents new recommendations from the 2002 CDC Guidelines for the Treatment of Sexually Transmitted Diseases in the context of current disease trends and public health.

  • This paper discusses tests of glycemia for the diagnosis of type 2 diabetes mellitus, with particular reference to the 1997 diagnostic criteria of the American Diabetes Association.

Review

  • This meta-analysis discusses postmenopausal hormone replacement therapy and the primary prevention of cardiovascular disease.

Editorials

  • In this issue, Kirk and colleagues provide important data on discontinuation of secondary prophylaxis after episodes of cytomegalovirus disease, Mycobacterium avium complex disease, toxoplasmosis encephalitis, and extrapulmonary cryptococcosis. However, questions remain about which patients can most safely discontinue secondary prophylaxis.

  • Advances in diagnostic testing have been among the most significant medical innovations of recent years, but they have not simplified the choice of diagnostic strategies. The need for an evidence-based approach to such choices has never been greater. With the article by Barr and colleagues, this issue inaugurates a series on the selection and interpretation of diagnostic tests.

  • The early stoppage and release of the main results of the estrogen plus progestin component of the Women's Health Initiative have caused millions of postmenopausal women to confront their medicine cabinets in confusion. In this issue, Humphrey and colleagues summarize data that pointed toward a sizable reduction in the risk for coronary events in women who took hormone replacement therapy after menopause.

On Being a Doctor

  • It was 11 December 1979, just past dawn. He was across the room from me, in an incubator because of a difficult birth. The most beautiful newborn I had ever seen.

On Being a Patient

  • “Doctor B. just walked in,” my receptionist said. “He wants to see you.” So, I said to myself, he finally made it. Five missed appointments in 3 months. I finished my coffee, got up, and faced him across a crowded waiting room.

Letters

Medical Writings: Book Notes

Current Clinical Issues

Book Listings

Medical Notices

Summaries for Patients