Table of Contents

October 21, 2003; 139 (8)

Articles

  • Topical application of nerve growth factor may be an effective therapy for patients with severe pressure ulcers.

  • In this prospective, community-based study, serum insulin-like growth factor I level was inversely related to the risk for congestive heart failure in elderly people without a previous myocardial infarction.

  • According to prospectively recorded data from a large clinical trial, patients whose colon cancer was resected at low-volume hospitals had a higher risk for long-term mortality; however, this increased mortality was not attributable to differences in colon cancer recurrence.

  • The presence of clustering represents variations in outcomes among providers with similar volumes. Thus, investigators of volume–outcome studies should characterize the degree of clustering of outcomes because doing so may provide insight into variations in quality of care.

Reviews

  • Among nonlipid serum markers, only C-reactive protein levels are significantly affected by statins. These findings suggest that statin-mediated anti-inflammatory effects may contribute to the ability of these drugs to reduce risk for cardiovascular disease. Overall, however, available data are insufficient to support recommendations for using nonlipid serum markers in decisions about statin therapy for individual patients.

  • Immune reactions to small molecular compounds, such as drugs, can cause many diseases involving the skin, liver, kidney, and lungs. This review examines how T cells recognize drugs; the cross-reactivity of drug-specific T cells; innate immunity and drug hypersensitivity; and drug-induced maculopapular, bullous, and pustular exanthema.

Editorials

  • In this issue, Landi and colleagues report on the topical treatment of pressure ulcers with nerve growth factor. Although the authors have shown that topical nerve growth factor was clearly superior to vehicle control in their study, future studies must be done to demonstrate whether this treatment is better than other conventional therapies.

  • Given the high stakes of surgical treatment, where should patients go when they need surgery? Common sense and a growing literature suggest that they should seek surgeons and hospitals that frequently perform the needed procedure. After all, practice makes perfect, doesn't it? The studies by Meyerhardt and Panageas and their colleagues reported in this issue suggest that the answer to this question is considerably more complicated than it appears.

On Being a Doctor

  • My first emotion was irritation. It was Friday afternoon around 5 o'clock, and it had been a particularly busy week. Then one of the nurses brought me one more patient message to deal with before I got out. “Mrs. Jones called to say that she has had blurred vision ever since she had that echo test this morning.” I smirked. Suddenly echocardiograms were mysteriously causing visual difficulties.

Letters

Medical Writings: Book Notes

Current Clinical Issues

Ad Libitum

Book Listings

Medical Notices

Summaries for Patients

Updates from the Annual Session

  • This Update discusses 3 important topics in oncology: screening (especially in the field of proteomics), prevention (including preventive measures for human papillomavirus), and therapeutics (including the use of imatinib for treating chronic myelogenous leukemia).