Table of Contents

September 16, 2003; 139 (6)

Articles

  • Use of macrolide antibiotics is associated with increased risk that subsequent infection with Helicobacter pylori will be clarithromycin resistant and that clarithromycin treatment will fail.

  • The prevalences of polycythemia vera and essential thrombocythemia in a general population were higher than expected. However, the risks for developing polycythemia vera, essential thrombocythemia, or associated vascular complications in persons with erythrocytosis or thrombocytosis were low.

  • Thiazide diuretics protect against hip fracture in persons 55 years of age and older. This effect disappears within 4 months after stopping thiazides.

Brief Communications

  • A common Helicobacter pylori regimen (clarithromycin, metronidazole, and omeprazole) selects for highly resistant enterococci that can persist in the gastrointestinal tract for at least 3 years.

  • The weight loss aids Chaso and Onshido may be associated with acute liver injury. These products contain N-nitroso-fenfluramine, a possibly hepatotoxic compound.

Academia and Clinic

  • The Conference on Guideline Standardization (COGS) convened to define recommendations on how to report a practice guideline. The proposed standard is a list of information that would help a potential guideline user to decide whether the guideline recommendations were valid and usable.

Reviews

  • This review discusses the pathogenesis, diagnosis, and treatment of giant-cell arteritis and polymyalgia rheumatica.

  • Ultrasonographic screening and elective repair have substantially reduced mortality from abdominal aortic aneurysms (AAAs). One-time ultrasonographic screening and elective repair when the AAA is 5.5 cm in diameter or larger is reasonable practice for 65- to 79-year-old men who have ever smoked.

Editorial

  • We are seldom able to treat an infecting bacterium without also doing significant “collateral damage” to our friendly microflora. The papers by McMahon and Sjölund and colleagues in this issue present 2 examples of collateral damage associated with the use of antimicrobial agents.

On Being a Doctor

  • Many of our work experiences we smooth and shape in the retelling like pebbles being polished by the tides. Some are more valuable for their sharp edges and the pain and lesson they bring by holding them tight.

Letters

Medical Writings: Book Notes

Current Clinical Issues

Book Listings

Medical Notices

Summaries for Patients

Updates from the Annual Session

  • This Update describes recent advances in treating pulmonary hypertension and outlines the issues surrounding proposals to screen for lung cancer by using low-dose computed tomography.