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Articles 
Steven T. Mast, James G. Jollis, Thomas Ryan, Kevin J. Anstrom, and Jack L. Crary In 50 patients who had developed at least mild mitral regurgitation or aortic regurgitation after exposure to fenfluramines, serial echocardiography showed that valvular regurgitation improved or remained stable in most patients after therapy was discontinued. Worsening of valvular regurgitation was uncommon.
Neil J. Weissman, Julio A. Panza, John F. Tighe, Jr., and John T. Gwynne The findings of this study suggest that after dexfenfluramine therapy is taken for 2 to 3 months and then discontinued, development or progression of any valvular regurgitation over the following year is unlikely. Echocardiographic evidence indicates that aortic regurgitation regresses in some previously treated patients.
Marc A.M. van Wijk, Johan van der Lei, Mees Mosseveld, Arthur M. Bohnen, and Jan H. van Bemmel Decision support based on guidelines was more effective in changing blood test–ordering behavior than was decision support based on initially displaying a limited number of tests. Guideline-driven decision support systems can reduce the number of laboratory tests ordered by primary care practitioners.
Brief Communications
Laura Kettel Khan, Mary K. Serdula, Barbara A. Bowman, and David F. Williamson According to the results of a telephone survey, nearly 5 million U.S. adults used prescription weight loss pills in 1996–1998. However, one quarter of users were not overweight, suggesting that weight loss pills may be inappropriately used, especially among women, white persons, and Hispanic persons.
Alyce M. Girardi, Leslie R. Pyenson, Jon Morris, and Francis X. Brickfield Incidence of and death from coronary heart disease among office-holding world leaders has decreased over the past 30 years, possibly because of increased use of cardiac procedures. A coronary event in a world leader is unlikely to presage a change in government.
Reviews
Marin H. Kollef and Victoria J. Fraser The authors discuss the risk factors associated with acquisition of antibiotic-resistant bacterial infections and potential strategies for preventing antibiotic resistance in the intensive care unit.
Perspectives
Jan P. Vandenbroucke Case reports and case series have been subject to some serious questioning, but they have their own valuable role in the progress of medical science.
NIH Conferences
Karel Pacak, W. Marston Linehan, Graeme Eisenhofer, McClellan M. Walther, and David S. Goldstein This conference report summarizes advances in the genetics, biochemical diagnosis, localization, and management of pheochromocytoma and notes key questions that remain unanswered.
Editorials
Martin St John Sutton The studies by Weissman and Mast and their colleagues in this issue clarify two important issues concerning anorexogen-induced valvulopathy: that progressive valvulopathy is uncommon and that valvular regurgitation may spontaneously resolve in some patients after cessation of anorexogen therapy.
J. Willis Hurst Girardi and colleagues' report in this issue suggests that most world leaders remain in power after a coronary event. In the United States, a president's physician, along with a White House physician and consultants, decides whether the president is disabled.
Letters Error in Medicine
Suppose There Were No Printers
Work–Family Balance
Seizure Associated with Ginkgo biloba?
Ibuprofen-Related Hypoglycemia in a Patient Receiving Sulfonylurea
Idiosyncratic Acute Hepatitis Caused by Paracetamol in Two Patients with Melanoma Treated with High-Dose Interferon- Conjunctival Icterus
Drug-Induced Thrombocytopenia: An Updated Systematic Review
Who Is a Peer?
Correction: Error in Medicine
James Mittelberger
Edward J. Huth
Tom Reynolds
Anna B. Reisman
Catherine Thaler
Anthony Montanaro and Stephen A. Tilles This Update focuses on topics in allergy and immunology that are particularly relevant to internal medicine: latex allergy, trimethoprim–sulfamethoxazole allergy, environmental controls for persons with allergies, food allergy, use of inhaled corticosteroids, use of monoclonal anti-IgE antibody, asthma, and allergic rhinitis. | ||||||||||||||||||||||||||||||||||||||||||||||||||||
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