Table of Contents

March 4, 2003; 138 (5)

Articles

  • A multivitamin and mineral supplement reduced the incidence of participant-reported infection and related absenteeism in persons with type 2 diabetes mellitus and a high prevalence of subclinical micronutrient deficiency. A larger clinical trial should be done to determine whether these findings can be replicated in other populations.

  • Although effects seem to differ by physician level of training, prompting physicians with alcohol screening results and recommendations for action can modestly increase discussions about alcohol use and advice to patients, and may decrease alcohol consumption.

  • Attempted weight loss is associated with lower all-cause mortality, independent of weight change. Self-reported intentional weight loss is associated with lower mortality rates, and weight loss is associated with higher mortality rates only if it is unintentional.

Brief Communications

  • Among applicants to medical residency programs, the authors found substantially less misrepresentation of authorship than had been reported. Previous studies probably overestimated the magnitude of the problem because their search strategies were not comprehensive.

Academia and Clinic

  • Homeopathy is being increasingly used throughout the world. This article describes the history and principles of homeopathy, its practice patterns, and current research.

Updates

  • The authors discuss neuropathologic changes associated with Alzheimer disease, their implications for diagnosis and treatment, detection of symptoms and clinical diagnosis, and potential new diagnostic tests.

Review

  • This case-based discussion focuses on the clinical presentation and diagnostic assessment of elderly patients with symptoms of mild memory problems. Such patients present a diagnostic challenge because one or more of the following may be present: normal, age-related cognitive changes, cognitive changes due to neurodegenerative illnesses, and depression-related cognitive impairment.

Perspectives

  • It is important to identify which overweight persons are most likely to be insulin resistant because they are at increased risk for developing coronary heart disease. Family history; blood pressure; and plasma glucose, triglyceride, and high-density lipoprotein cholesterol levels all help to identify the subset of persons who will benefit the most from intense therapeutic efforts to lose weight.

NIH Conferences

  • This National Institutes of Health conference discussed the following aspects of clinically inapparent adrenal masses: causes, prevalence, and natural history; appropriate evaluation; criteria for guiding the choice between surgical and nonsurgical management; the appropriate surgical procedure, if indicated; appropriate follow-up; and additional research needed to guide practice.

Editorial

  • Vitamin supplements are inexpensive and might improve health status in settings where infections are major public health problems. In developed countries, infections pose important economic burdens. As suggested by Barringer and colleagues' study in this issue, the potential impact of supplements merits further rigorous study, especially among diabetic persons and other vulnerable populations.

On Being a Doctor

  • The first book I can remember was about Ping, a little yellow duck that lived on the Yangtze River. I am certain that Ping had drawn me to China, in particular to the Yangtze River, perhaps to find Ping. On an evening flight from Guilin to Chongqing, I most unexpectedly found my Ping.

On Being a Patient

  • Alternative medicine is in the news these days, welcomed as an elective for people who are uninsured, uninsurable, or discontented with the current bureaucracy of healing. I've joined the nonconformists and would like to suggest one more string to their bow—one more option that has received very little notice of late. Its cost is nominal, it offers broad coverage, and it imposes few unpleasant side effects. Flowers.

Letters

Medical Writings

  • Physicians often deal with hope as something to embrace or negate completely. But this exclusive focus on hope constricts options for discussing how a patient, family, and physician can work together with a life-threatening illness. Embracing a dual approach of hoping for the best and preparing for the worst helps physicians join with patients and families, yet plan medical care that is responsive to a range of potential outcomes.

Medical Writings: Book Notes

Ad Libitum

Book Listings

Medical Notices

Summaries for Patients