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Articles 
Javier Martinez-Picado, Eugènia Negredo, Lidia Ruiz, Ayumi Shintani, Carmina R. Fumaz, Carlos Zala, Pere Domingo, Josep Vilaró, Josep M. Llibre, Pompeyo Viciana, Kurt Hertogs, Charles Boucher, Richard T. D'Aquila, Bonaventura Clotet the SWATCH Study Team* This pilot study randomly assigned patients to receive one of two triple-drug regimens (stavudine, didanosine, and efavirenz or zidovudine, lamivudine, and nelfinavir) or to alternate between the two regimens every 3 months. Alternating the regimens delayed virologic failure.
Adrienne A.M. Zandbergen, Marinus G.A. Baggen, Steven W.J. Lamberts, Aart H. Bootsma, Dick de Zeeuw, and Rob J.Th. Ouwendijk The angiotensin-receptor antagonist losartan reduces urinary albumin excretion in normotensive patients with type 2 diabetes and microalbuminuria. The effect of losartan on proteinuria is independent of its effect on blood pressure.
Andrea Z. LaCroix, Jane A. Cauley, Mary Pettinger, Judith Hsia, Douglas C. Bauer, Joan McGowan, Zhao Chen, Cora E. Lewis, S. Gene McNeeley, Maureen D. Passaro, and Rebecca D. Jackson Statin use did not reduce fracture risk or increase bone density in the Women's Health Initiative Observational Study. The accumulated evidence does not support using statins to prevent or treat osteoporosis.
Philip Kam-Tao Li, Kai-Ming Chow, Teresa Yuk-Hwa Wong, Chi-Bon Leung, and Cheuk-Chun Szeto The angiotensin-converting enzyme inhibitor ramipril may reduce the rate of decline in residual renal function in patients who have end-stage renal failure and are undergoing peritoneal dialysis.
Academia and Clinic
Joan M. Neuner, Mary Beth Hamel, Russell S. Phillips, Kira Bona, and Mark D. Aronson Observation, culture, and two rapid antigen test strategies for diagnosing and treating suspected group A ß-hemolytic streptococcal (GAS) pharyngitis in adults have very similar cost-effectiveness. Culture is the least expensive and most effective strategy for pharyngitis when the probability of GAS is 10% or greater. Empirical antibiotic treatment is never the best strategy in adults, except possibly in patients with a very high probability of GAS.
Reviews
Glenn N. Levine, Morton J. Kern, Peter B. Berger, David L. Brown, Lloyd W. Klein, Dean J. Kereiakes, Timothy A. Sanborn, Alice K. Jacobs for the American Heart Association Diagnostic and Interventional Catheterization Committee and Council on Clinical Cardiology This review discusses the risks and complications of percutaneous coronary revascularization, as well as optimum patient management before, during, and after the procedure.
Clinical Guidelines
Andrew S. Levey, Josef Coresh, Ethan Balk, Annamaria T. Kausz, Adeera Levin, Michael W. Steffes, Ronald J. Hogg, Ronald D. Perrone, Joseph Lau, and Garabed Eknoyan This paper describes a classification system for chronic kidney disease and summarizes recommendations on early detection in adults. Key recommendations include identifying persons at increased risk, using the albumin–creatinine ratio in untimed urine specimens, and using prediction equations to estimate the glomerular filtration rate from the serum creatinine level.
Editorials
Michael Saag In Martinez-Picado and colleagues' study reported in this issue, fewer virologic failures occurred with alternating antiretroviral regimens than with continuous treatment with one triple-drug regimen. However, several subtleties in the study design and the analysis raise questions about the meaning of the findings and their application to clinical practice.
Alan L. Bisno In this issue, Neuner and colleagues report a cost-effectiveness analysis of the diagnosis and treatment of adults with pharyngitis caused by group A ß-hemolytic streptococcus. Contrary to a recent American College of Physicians practice guideline, they found that treatment based on history and physical findings alone was the least effective strategy. Until controlled clinical studies measure the added value of the rapid antigen test or culture for GAS, the author does not believe it is prudent to rely exclusively on clinical criteria to diagnose and manage pharyngitis.
Letters Empathy and the Literary Imagination
Torsades de Pointes Due to Methadone
Sudden-Onset Thrombocytopenia with Oxaliplatin
Complementary and Alternative Medicine in Cancer
Propensity Scores for Rare Outcomes and Common Treatments
A Lesson in Poverty
Herpes Simplex Virus–Associated Sepsis in a Previously Infected Immunocompetent Adult
The Impact of Methadone Induction on Cardiac Conduction in Opiate Users
Correction: Advising Patients Who Seek Complementary and Alternative Medical Therapies for Cancer
Thomas R. Yackel
Anthony J. DiMarino, Jr
Jennifer Fisher Wilson
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