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Articles 
Marcia Valenstein, Sandeep Vijan, John E. Zeber, Kathryn Boehm, and Amna Buttar Annual and periodic screening for depression in primary care cost more than $50 000/quality-adjusted life-year, but one-time screening is cost-effective. The cost-effectiveness of screening is likely to improve if treatment becomes more effective.
Loren Laine, Philip Schoenfeld, and M. Brian Fennerty This meta-analysis provides little support for the use of Helicobacter pylori eradication therapy in patients with nonulcer dyspepsia.
The ACE Inhibitors in Diabetic Nephropathy Trialist Group* In normotensive patients with type 1 diabetes mellitus and microalbuminuria, angiotensin-converting enzyme (ACE) inhibitors significantly reduced progression to macroalbuminuria and increased chances of regression. Beneficial effects were weaker at the lowest levels of microalbuminuria but did not differ according to other baseline risk factors. Changes in blood pressure cannot entirely explain the antiproteinuric effect of ACE inhibitors.
Brief Communications
Toshifumi Ohkusa, Kazuhiko Fujiki, Ichizen Takashimizu, Jiro Kumagai, Toru Tanizawa, Yoshinobu Eishi, Tetsuji Yokoyama, and Mamoru Watanabe In the year after successful Helicobacter pylori eradication, precancerous lesions improved in most patients who had had dyspepsia and H. pylori infection.
Updates
Robert K. Schneider, James L. Levenson, and Sidney H. Schnoll The literature described in this Update is intended to provide information about addiction medicine that may not be readily available to internists. The information is broadly divided into the following categories: nomenclature, alcohol, opioids, tobacco, cocaine, club drugs, marijuana, and psychogenetics.
Reviews
Jennifer R. Santiago, Michael S. Nolledo, Wendy Kinzler, and Teodoro V. Santiago This review discusses sleep changes in normal pregnancy and sleep disorders occurring in the pregnant woman, including physiologic bases for alterations in sleep and changes in respiratory physiology during pregnancy.
History of Medicine
Jack Hirsh and Shannon M. Bates The authors review the important clinical trials involving anticoagulant therapy and vena caval interruption. The studies are discussed from a historical perspective, and an attempt is made to analyze both the thought processes that prompted their design and the reasons why they changed practice.
Editorials
Kurt Kroenke The findings of Valenstein and colleagues in this issue do not imply that detecting depression is unimportant. Instead, the authors' cost–utility analysis raises questions about universal screening (as opposed to selective case finding) and about merely improving detection without simultaneously enhancing treatment and follow-up.
James C. Cobey and Nathaniel A. Raymond Antipersonnel land mines are an epidemic that has afflicted the world's poorest, war-wrecked nations, maiming and killing scores of civilians each year. In the final analysis, the Mine Ban Treaty is the only vaccine for the mine epidemic. As physicians know so well, prevention is the best medicine.
Letters Tragic Events of April 1996
Losartan Reduces Hematocrit in Patients with Chronic Obstructive Pulmonary Disease and Secondary Erythrocytosis
Possible Drug Interaction between Itraconazole and Vinorelbine Tartrate Leading to Death after One Dose of Chemotherapy
Mark E. Silverman and J. Willis Hurst Few remember James Edgar Paullin. Yet during the 1940s, he was one of the best known and most influential physicians in the United States. His most famous patient was Franklin Delano Roosevelt.
Rebecca J. Kurth
Anne W. Moulton
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