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Articles 
Tazeen H. Jafar, Christopher H. Schmid, Marcia Landa, Ioannis Giatras, Robert Toto, Giuseppe Remuzzi, Giuseppe Maschio, Barry M. Brenner, Annelise Kamper, Pietro Zucchelli, Gavin Becker, Andres Himmelmann, Kym Bannister, Paul Landais, Shahnaz Shahinfar, Paul E. de Jong, Dick de Zeeuw, Joseph Lau, Andrew S. Levey the ACE Inhibition in Progressive Renal Disease Study Group* Antihypertensive regimens that include angiotensin-converting enzyme (ACE) inhibitors are more effective than regimens without these drugs in slowing the progression of nondiabetic renal disease. The beneficial effect of ACE inhibitors is mediated by factors in addition to decreasing blood pressure and urinary protein excretion and is greater in patients with proteinuria. Angiotensin-converting enzyme inhibitors are indicated for treatment of nondiabetic patients with chronic renal disease and proteinuria and, possibly, those without proteinuria.
Arnaud Perrier, Nigel Howarth, Dominique Didier, Pierre Loubeyre, Pierre-François Unger, Philippe de Moerloose, Daniel Slosman, Alain Junod, and Henri Bounameaux Helical computed tomography should not be used alone for suspected pulmonary embolism but could replace angiography in combined strategies that include ultrasonography and lung scanning.
Philip S. Wells, David R. Anderson, Marc Rodger, Ian Stiell, Jonathan F. Dreyer, David Barnes, Melissa Forgie, George Kovacs, John Ward, and Michael J. Kovacs Managing patients for suspected pulmonary embolism on the basis of pretest probability and D-dimer test result is safe and decreases the need for diagnostic imaging.
Brief Communications
Clive Kearon, Jeffrey S. Ginsberg, James Douketis, Mark Crowther, Patrick Brill-Edwards, Jeffrey I. Weitz, and Jack Hirsh The combination of a low pretest probability of deep venous thrombosis and a negative result on a whole-blood D-dimer test rules out deep venous thrombosis in a large proportion of symptomatic outpatients.
Academia and Clinic
A. Russell Localio, Jesse A. Berlin, Thomas R. Ten Have, and Stephen E. Kimmel Investigators increasingly rely on multicenter or multigroup studies to demonstrate effectiveness and generalizability. Authors too often overlook the analytic challenges in these study designs: the correlation of outcomes and exposures among patients within centers, confounding of associations by center, and effect modification of treatment or exposure across center.
Updates
Rebecca A. Kazin, Nancy R. Lowitt, and Mark H. Lowitt The authors highlight and discuss 10 articles from the past 2 years that illustrate progress in dermatologic areas of interest to the internist. Topics include hepatitis C virus infection, herpes simplex viruses, and common skin diseases such as basal-cell carcinoma.
Perspectives
Andrew G. Bostom, Jacob Selhub, Paul F. Jacques, and Irwin H. Rosenberg Fortification of cereal grain flour with folic acid has dramatically affected the occurrence of mild hyperhomocysteinemia and responsiveness to total homocysteine–lowering treatment in people with cardiovascular disease who are free of chronic renal insufficiency. As a result, ongoing trials of total homocysteine–lowering therapy for the potential reduction of cardiovascular disease outcomes may be underpowered.
Editorials
Robert W. Schrier and Raymond O. Estacio Jafar and colleagues' meta-analysis in this issue contributes evidence on strategies to slow nondiabetic renal progression by use of angiotensin-converting enzyme inhibitors. However, the authors' conclusion, although perhaps correct, must be considered tentative.
Letters Association of Hepatitis C and Diabetes Mellitus
Cocaine-Related Vasculitis Causing Upper-Limb Peripheral Vascular Disease
Severe Hepatitis in a Patient Taking Cetirizine
Nelson M. Gantz
Lori A. Bastian
Linda Gundersen
Harold E. Carlson
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