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Articles 
Sam T. Donta, Charles C. Engel, Jr., Joseph F. Collins, Joel B. Baseman, Lisa L. Dever, Thomas Taylor, Kathy D. Boardman, Lewis E. Kazis, Suzanne E. Martin, Rebecca A. Horney, Annette L. Wiseman, Douglas S. Kernodle, Raymond P. Smith, Aldona L. Baltch, Christine Handanos, Brian Catto, Luis Montalvo, Michael Everson, Warren Blackburn, Manisha Thakore, Sheldon T. Brown, Larry Lutwick, Dorothy Norwood, Jack Bernstein, Catherine Bacheller, Bruce Ribner, L. W. Preston Church, Kenneth H. Wilson, Prabhakar Guduru, Robert Cooper, Joseph Lentino, Richard J. Hamill, Arnold B. Gorin, Victor Gordan, David Wagner, Cliff Robinson, Pierre DeJace, Ronald Greenfield, Lisa Beck, Marvin Bittner, H. Ralph Schumacher, Fredric Silverblatt, James Schmitt, Edward Wong, Margaret A.K. Ryan, Javier Figueroa, Christopher Nice, John R. Feussner the VA Cooperative #475 Group Researchers have hypothesized that certain Mycoplasma species may cause Gulf War veterans' illnesses (chronic diseases characterized by pain, fatigue, and cognitive symptoms) and that affected patients may benefit from doxycycline treatment. This study found that long-term treatment with doxycycline did not improve outcomes of these illnesses at 1 year.
Chi-yuan Hsu, Eric Vittinghoff, Feng Lin, and Michael G. Shlipak Growth in incident end-stage renal disease (ESRD) outpaced growth in prevalent chronic renal insufficiency, demonstrating that the ESRD epidemic in the United States is not merely due to more cases of kidney disease. Other potential contributors to ESRD growth are improved survival from nonrenal diseases and more liberal entry criteria for treatment programs.
Louise Pilote, Michal Abrahamowicz, Eric Rodrigues, Mark J. Eisenberg, and Elham Rahme Survival benefits in the first year after acute myocardial infarction in patients 65 years of age or older seem to differ according to the specific angiotensin-converting enzyme inhibitor prescribed. Ramipril was associated with lower mortality than most other drugs in this class.
Howard B. Degenholtz, YongJoo Rhee, and Robert M. Arnold Living wills are associated with dying in a patient's residence rather than in a hospital. During advance care planning, physicians should discuss patients' preferences for location of death.
Improving Patient Care
Christianne L. Roumie, Eric L. Grogan, William Falbe, Joseph Awad, Theodore Speroff, Robert S. Dittus, and Tom A. Elasy A multicomponent intervention (patient notification, provider education, electronic alerts in patient chart) seemed to increase the rate of stopping hormone replacement therapy after the release of results from the Women's Health Initiative study in July 2002.
Academia and Clinic
Troyen A. Brennan and Thomas H. Lee The authors describe a patient who believes she is allergic to generic medications and a physician who refuses to prescribe brand-name drugs when generic alternatives are available. They discuss the ethical dilemmas of the patient's physician, who must weigh the interests of a patient who clings to beliefs that the physician thinks are unfounded against the interests of a just rationing program and the broader population it serves.
Gail J. Povar, Helen Blumen, John Daniel, Suzanne Daub, Lois Evans, Richard P. Holm, Natalie Levkovich, Alice O. McCarter, James Sabin, Lois Snyder, Daniel Sulmasy, Peter Vaughan, Laurence D. Wellikson, Amy Campbell the Medicine as a Profession Managed Care Ethics Working Group* This statement offers guidance on preserving the patient–physician relationship; patient rights and responsibilities; confidentiality and privacy; resource allocation and stewardship; the obligation of health plans to foster an ethical environment for the delivery of care; and the physician's responsibility to individual patients, the community, and the public health.
Reviews
Yiqing Song, Meir J. Stampfer, and Simin Liu Previous studies on apolipoprotein E (apoE)
Stephen E. Possick and Michèle Barry In the context of a case presentation, the authors review the data on safe air travel after myocardial infarction and common complications of air travel after coronary artery revascularization; provide recommendations on safe air travel after myocardial infarction; discuss the safety of preflight screening and the in-flight environment for patients with pacemakers and implantable automatic defibrillators; and provide recommendations to prevent in-flight deep venous thrombosis.
Editorials
Simon Wessely In this issue, Donta and colleagues report that doxycycline treatment has no effect on the health of symptomatic Gulf War veterans and that serologic evidence of Mycoplasma infection was unrelated to health. In the future, we cannot recommend long-term treatment with doxycycline or similar compounds for symptomatic veterans. It would, however, be naive to expect that this negative trial will be the end of the matter.
Sean Hennessy and Stephen E. Kimmel Pilote and colleagues' study in this issue indicates that in the absence of head-to-head randomized trials that test survival benefits of different angiotensin-converting enzyme inhibitors, the current level of scientific evidence is not sufficient to justify the selection of one proven drug in this class over another.
Joan M. Teno In principle, increasing the use of advance directives is important. However, they are not sufficient to address the important concerns of family members of dying patients. We must move from a focus on single interventions, such as the living will, to public policies that use multifaceted interventions to provide competent, coordinated, and compassionate end-of-life care.
Letters Pathogenesis of Hypertension
Late Sequelae of Induced Abortion
Costs of False-Positive Cultures from Central Catheters
An "Inexcusable" Case of Muscle Rigidity and Shortness of Breath
Correction: Successful Treatment of Refractory Sarcoidosis-Associated Uveitis with Infliximab
Marilyn Terranella
Kate Scannell
Jennifer Fisher Wilson
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4 allele as a risk factor for coronary heart disease have had conflicting results. This meta-analysis found that the apoE 