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Articles 
Marcia L. Burman, Stephen H. Taplin, Douglas F. Herta, and Joann G. Elmore Among women with no history of breast cancer, having a false-positive mammogram did not adversely affect screening behavior in the next recommended interval. Women with false-positive mammograms, especially those without previous mammography, were more likely to return for the next scheduled screening.
Bruce F. Culleton, Martin G. Larson, William B. Kannel, and Daniel Levy Despite previous suggestions to the contrary, uric acid does not have a causal role in the development of coronary heart disease, death from cardiovascular disease, or death from all causes. Any apparent association with these outcomes is probably due to the association of uric acid level with other risk factors.
Jacqueline K. Benedetti, Judith Zeh, and Lawrence Corey Herpes simplex virus type 2 infection continues to be a chronic remitting illness. Over time, however, clinically significant reductions in the frequency of recurrence occur in a majority of patients.
Tomoshige Hayashi, Kei Tsumura, Chika Suematsu, Kunio Okada, Satoru Fujii, and Ginji Endo Walking to work and other types of physical activity decreased the risk for hypertension in Japanese men. These findings suggest that regular exercise can slow the development of hypertension.
Brief Communications
Mette Axelsen, Ulf Smith, Jan W. Eriksson, Marja-Riitta Taskinen, and Per-Anders Jansson In this study, healthy male first-degree relatives of patients with type 2 diabetes were insulin resistant and exhibited postprandial lipid intolerance despite having normal fasting triglyceride levels. These characteristics, which occur in the absence of glucose intolerance, are associated with an increased risk for macroangiopathy.
Daniel F. Hoft and Jan M. Tennant Previous Bacille Calmette-Guérin (BCG) vaccination reduces the predictive value of serial purified protein derivative testing. The lowest BCG predictive values will occur in persons without known tuberculosis exposure who were vaccinated recently or many times with intradermal BCG.
Academia and Clinic
Janet L. Abrahm for the ACP-ASIM End-of-Life Care Consensus Panel Pain and spinal cord compression are two of the most distressing problems faced by patients with advanced cancer. This paper uses a case study to illustrate an evidence-based approach to the most common clinical challenges such patients present.
Reviews
Steven M. Hollenberg, Clifford J. Kavinsky, and Joseph E. Parrillo Improved understanding of the pathophysiology of shock and myocardial infarction has led to improved treatment. If cardiogenic shock is managed with rapid evaluation and prompt initiation of supportive measures and definitive therapy, outcomes can improve.
Editorials
Suzanne W. Fletcher False-positive results on screening tests can lead to several negative consequences. In the case of breast cancer, do women with a false-positive mammogram forgo future screening mammograms? In this issue, Burman and colleagues address that question.
Viola Vaccarino and Harlan M. Krumholz In this issue, Culleton and colleagues from the Framingham Heart Study resolve the long-standing controversy surrounding the role of uric acid as a risk factor for cardiovascular disease. Enthusiasm for new cardiovascular risk factors should be accompanied by efforts to evaluate their independent association with the incidence of cardiovascular disease and their practical clinical utility.
Frank Davidoff Annals is again an official sponsor of the Seventh International Colloquium of the Cochrane Collaboration. The Collaboration, whose purpose is to search out and combine the results of the best clinical studies, will hold this meeting from 5 to 9 October 1999 in Rome.
Frank Davidoff In August 1998, a new journal, Effective Clinical Practice, appeared on the scene. With thousands of journals already out there, why another journal at this time?
On Being a Doctor
Anne L. Peters Working as a physician, I have collected people's life tales as I obtain their medical details. Putting people in their personal context helps me understand how they may internalize the medical advice I dispense. Attending Jim's memorial service provided a large dose of context.
Letters Nitric Oxide and Impaired Oxygenation before and after Liver Transplantation
Psychotherapy for Depression in Diabetes
Coronary Thrombolysis: A Double-Edged Sword?
Plasmapheresis in Thyrotoxicosis
Elevated International Normalized Ratio Associated with Trovafloxacin
Tardive Dyskinesia Associated with Olanzapine
Do-Not-Resuscitate Orders in Radiology Departments
Contemplating the White Coat
Correction: Update in Pulmonary Medicine
Russell C. Maulitz As the ship of U.S. medicine drifts toward the millennium, we peer out warily from the deck and wonder what lies ahead—or whether a rudder is down below. This paper surveys recent historical works on specialization in an attempt to locate what little stability we might find in this sea of change.
Harvey Rubin
William W. Frailey, Jr.
Jack Ende
Paula Tatarunis
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