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Articles 
David T. Felson, Christine E. Chaisson, Catherine L. Hill, Saara M.S. Totterman, M. Elon Gale, Katherine M. Skinner, Lewis Kazis, and Daniel R. Gale Bone marrow lesions on magnetic resonance imaging are strongly associated with the presence of pain in knee osteoarthritis.
James M. Brophy, Lawrence Joseph, and Jean L. Rouleau ß-Blocker therapy is associated with clinically meaningful reductions in mortality and morbidity in patients with stable congestive heart failure and should be routinely offered to all patients who are similar to those included in trials.
Douglas C. Bauer, Bruce Ettinger, Michael C. Nevitt, Katie L. Stone for the Study of Osteoporotic Fractures Research Group Women older than 65 years of age who have low serum thyroid-stimulating hormone (TSH) levels, which indicate physiologic hyperthyroidism, are at increased risk for new hip and vertebral fractures. Use of thyroid hormone itself does not increase risk for fracture if TSH levels are normal.
Brief Communications
Hans Feenstra, Rick E. Grobbee, Bas A. in't Veld, and Bruno H.Ch. Stricker Outcomes may differ in treated and untreated patients as a result of a contraindication for treatment in untreated patients that is independently associated with the outcome of interest. This study evaluated the effects of confounding by contraindication on risk factors for death in patients taking ibopamine after use of the drug was restricted in the Netherlands.
Reviews
Valeria Santini, Hagop M. Kantarjian, and Jean-Pierre Issa The authors review the biological rationale for targeting aberrant methylation in cancer therapy and summarize completed phase I and II trials of this approach, some of which show promise for treatment of hematologic malignancies.
Perspectives
Jerome P. Kassirer When it comes to setting standards of accountability and ethical behavior, medical institutions and professional organizations have often faltered. In the guise of accountability, their efforts have often yielded lax standards that were intentionally and flagrantly self-serving. This is pseudoaccountability.
Position Papers
Vincenza Snow, Steven Lascher, Christel Mottur-Pilson for the Joint Expert Panel on Chronic Obstructive Pulmonary Disease of the American College of Chest Physicians and the American College of Physicians–American Society of Internal Medicine* This guideline presents the available evidence on risk stratification for relapse of chronic obstructive pulmonary disease (COPD) and 6-month mortality rates, diagnostic testing for acute exacerbations of COPD, and current treatment options for acute exacerbations of COPD.
Peter B. Bach, Cynthia Brown, Sarah E. Gelfand, and Douglas C. McCrory The primary aims of this paper are 1) to summarize and evaluate published data that address care of patients with acute exacerbations of chronic obstructive pulmonary disease and 2) to improve the care that these patients receive by identifying efficacious and inefficacious treatments. This paper provides the background evidence for the clinical practice guideline in this issue.
Editorials
Alfred Jay Bollet In this issue, Felson and colleagues describe edema in the subarticular bone marrow adjacent to the knee in patients with painful knee osteoarthritis. This finding suggests that edematous changes in the subcortical bone marrow are one of the many sources of pain in patients with osteoarthritis. At present, this observation helps more in considering measures to minimize the stimuli that produce the pain rather than in treating pain once it develops.
On Being a Doctor
James S. Goodwin Whatever my initial emotional reaction to patients, it is difficult for me to dislike any of them for a prolonged period. I get to know them too well. They become far too interesting.
On Being a Patient
Emil P. Lesho This year, the anniversary of my father's death hurt more than ever. I began to wonder how often I appeared to the children of my seriously ill patients like the doctors who took care of my father when I was a boy.
Letters Adherence to Protease Inhibitors
Cost–Utility Analysis
Giant-Cell Arteritis of the Female Genital Tract
James Westphal
Lynn M. Manfred
Bonnie Salomon
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