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Articles 
Gregory M. Lucas, Richard E. Chaisson, and Richard D. Moore Unselected patients in whom highly active antiretroviral therapy is started in a clinic setting achieve viral suppression substantially less frequently than do patients in controlled clinical trials. Missed clinic visits were the most important risk factor for failure to suppress HIV-1 RNA levels.
Gideon Steinbach, Richard Ford, Gary Glober, Dory Sample, Frederick B. Hagemeister, Patrick M. Lynch, Peter W. McLaughlin, Maria A. Rodriguez, Jorge E. Romaguera, Andreas H. Sarris, Anas Younes, Rajyalakshmi Luthra, John T. Manning, Constance M. Johnson, Sandeep Lahoti, Yu Shen, Jeffrey E. Lee, Rodger J. Winn, Robert M. Genta, David Y. Graham, and Fernando F. Cabanillas A subset of Helicobacter pylori–positive gastric mucosa-associated lymphoid tissue lymphomas, including infiltrative tumors, may respond to antibiotic treatment. The likelihood of early complete remission seems to be greatest for superficial and distal tumors.
E. Wesley Ely, Gregory W. Evans, and Edward F. Haponik It has been argued that life support for the elderly should be limited to conserve resources. In this study, after adjustment for severity of illness, elderly patients spent similar lengths of time on mechanical ventilation and in the intensive care unit and hospital but had a lower cost of care than younger patients. These differences are not explained by differences in mortality rates.
Ranjan P. Ghose, Phillip M. Hall, and Emmanuel L. Bravo Medical management of aldosterone-producing adenomas is a viable option for controlling blood pressure and serum potassium levels.
Brief Communications
Terri R. Fried, Carol van Doorn, John R. O'Leary, Mary E. Tinetti, and Margaret A. Drickamer Preference for home as the site of care for terminal illness exceeds existing practice. However, the current debate about home versus hospital as the ideal site for end-of-life care may ignore an issue important to older persons—namely, the care of disabilities that precede death.
Jacques G.H. Gubler, Marcel Kuster, Fabrizio Dutly, Fridolin Bannwart, Martin Krause, Hans Peter Vögelin, Gianni Garzoli, and Martin Altwegg Cardiac manifestations of Whipple disease are rarely diagnosed before autopsy. In four patients with culture-negative endocarditis, the absence of clinical, microscopic, or microbiological evidence of gastrointestinal disease did not rule out Tropheryma whippelii.
Academia and Clinic
Steven H. Brown, Randolph A. Miller, Henry N. Camp, Dario A. Guise, and H. Kenneth Walker The authors describe a novel, empirical approach to deriving an electronic, clinically useful, canonical problem list vocabulary. The resulting Canonical Clinical Problem Statement System was compared with existing vocabularies used by the National Library of Medicine.
Reviews
Elizabeth J. Suh-Burgmann and Annekathryn Goodman This paper reviews the literature on the occurrence of endometrial cancer in women taking tamoxifen and the usefulness of various screening methods in this setting. Risk factors and screening criteria for endometrial cancer in the general population are discussed, and a strategy for surveillance of women taking tamoxifen is proposed.
Perspectives
Frederick M. Hecht, Ira B. Wilson, Albert W. Wu, Robert L. Cook, Barbara J. Turner for the Society of General Internal Medicine AIDS Task Force Treatment advances and outcomes data have raised new concerns about how to optimize care for patients with HIV infection. What is the role of experience and expertise in optimizing outcomes for these patients? What is the role of primary care skills in high-quality HIV care? How good is primary care physicians' basic HIV knowledge in screening and prevention?
Editorials
Didier Raoult In this issue, Gubler and colleagues report that chronic afebrile endocarditis could be caused by Whipple disease bacterium in patients whose clinical picture does not suggest classic infective endocarditis. Our knowledge of Whipple disease is growing rapidly, but culture of the bacterium is necessary to develop a serologic test and to determine whether the bacterium is a unique pathotype.
Anthony E. Voytovich Brown and colleagues, in this issue, describe their elegant and ambitious efforts to distill a workable canonical vocabulary from the large number of raw problem statements used in one institution. What are the benefits of a more critical use of words and diagnostic concepts?
On Being a Doctor
Tim Wolter The three Fates stood in judgment of human fortunes, from which there could be no appeal. Despite our ever-increasing medical knowledge, the Fates still seem to be at work.
On Being a Patient
Ruth Bendor Pain is the leitmotif of my life, but despite all the restrictions I'm still able to lead a self-reliant, happy existence.
Letters Risk Factors for Infective Endocarditis
Cholesterol Lowering in Older Patients
Vitamin C Increases Nitric Oxide Availability in Coronary Atherosclerosis
Graves Disease after Bone Marrow Transplantation
Celiac Disease during Interferon Treatment
Life, Death, and AIDS
Iron in Multivitamin Supplements
Aradhana Venkatesan and Mark Aronson
Albert B. Knapp
Michael D. Fetters
Aaron Levin
Kathleen Franco-Bronson
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