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Articles 
Paolo Prandoni, Anthonie W.A. Lensing, Martin H. Prins, Michela Frulla, Antonio Marchiori, Enrico Bernardi, Daniela Tormene, Laura Mosena, Antonio Pagnan, and Antonio Girolami Chronic post-thrombotic sequelae develop in almost half of patients with proximal deep venous thrombosis. Ready-made below-knee elastic compression stockings reduce this rate by 50%.
Elizabeth H. Morrison, Lloyd Rucker, John R. Boker, Charles C. Gabbert, F. Allan Hubbell, Maurice A. Hitchcock, and Michael D. Prislin The authors randomly assigned pediatrics, family medicine, and internal medicine residents to receive a 13-hour longitudinal residents-as-teachers curriculum or to a control group. Residents assigned to the curriculum consistently showed greater improvement in teaching skills, as judged by medical student raters.
Pauline A. Mysliwiec, Martin L. Brown, Carrie N. Klabunde, and David F. Ransohoff In response to 4 clinical scenarios on a national survey, gastroenterologists and general surgeons recommended surveillance colonoscopy after removal of low-risk polyps far more often than practice guidelines recommended. The demand for surveillance colonoscopy probably exceeds medical need.
Improving Patient Care
Eve A. Kerr, Robert B. Gerzoff, Sarah L. Krein, Joseph V. Selby, John D. Piette, J. David Curb, William H. Herman, David G. Marrero, K.M. Venkat Narayan, Monika M. Safford, Theodore Thompson, and Carol M. Mangione Diabetes care met process of care criteria more often in the Veterans Affairs (VA) system than in commercial managed care. Moreover, VA patients met standards for control of hemoglobin A1c and low-density lipoprotein cholesterol levels more often than did patients in commercial managed care. However, both systems had room for improvement in blood pressure control.
Perspectives
Ezekiel J. Emanuel, Anne Wood, Alan Fleischman, Angela Bowen, Kenneth A. Getz, Christine Grady, Carol Levine, Dale E. Hammerschmidt, Ruth Faden, Lisa Eckenwiler, Carianne Tucker Muse, and Jeremy Sugarman Many observers believe that oversight of research involving human participants is inadequate. The authors delineate 15 problems with the current system, critically assess proposed reforms, and outline components of a new proposal for reform.
In the Balance
James M. Brophy and Peter Bogaty This review critically analyzes the evidence comparing primary percutaneous coronary intervention (PCI) with thrombolytic therapy and concludes that reasonable health care professionals may still find considerable uncertainty about the superiority of primary PCI for all situations.
Ellen C. Keeley and Cindy L. Grines The authors contend that because primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction has superior outcomes, it should be available to all patients with ST-segment elevation myocardial infarction. They outline obstacles to instituting PCI as the universal treatment and propose strategies to increase its availability.
Clinical Guidelines
Peter Dodek, Sean Keenan, Deborah Cook, Daren Heyland, Michael Jacka, Lori Hand, John Muscedere, Debra Foster, Nav Mehta, Richard Hall, Christian Brun-Buisson for the Canadian Critical Care Trials Group and the Canadian Critical Care Society This article describes an evidence-based clinical practice guideline for preventing ventilator-associated pneumonia.
Editorials
Jeffrey S. Ginsberg What is a clinician to do to prevent long-term complications of acute symptomatic deep venous thrombosis? Should all patients routinely use elastic compression stockings over the long term, or can clinicians use a "wait-and-see" approach? The safest approach, on the evidence from the randomized trial reported in this issue, is routine stocking therapy.
Sheldon Greenfield and Sherrie H. Kaplan The improvement of diabetes care in the Veterans Affairs and other closed health care systems represents major progress toward optimal management for chronic diseases. Applying the experience of these organizations to the broader, less organized U.S. health care delivery system will be a far more serious challenge.
On Being a Patient
Peter S. Stack Alex, like others with autism, can't see the forest when standing in front of a tree. Rather, he is inexplicably drawn to minute details of one specific tree, a fixation that defies rational explanation. In Alex's case, the fixation is on elevators.
Letters ß-Blocker-Induced Quadriparesis
Hassane Izzedine, Vincent Launay-Vacher, Jean Sebastien Hulot, Damien Sternberg, and Gilbert Deray Coffee Consumption and Type 2 Diabetes Mellitus
Chest Pain Relief by Nitroglycerin
Assessment of Patients with Chest Pain
The Patient Safety Movement Will Help, Not Harm, Quality
Dexamethasone and Pneumococcal Meningitis
Brent A. Bauer
Howard M. Spiro
Jennifer Fisher Wilson
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