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Robert S. Sandler, MD, MPH; Nora L. Zorich, MD, PhD; Thomas G. Filloon, PhD; Heather B. Wiseman; Dennis J. Lietz, BBA; Michael H. Brock, MS; Mary G. Royer, MS; and Robert K. Miday, MD

Clinically meaningful or bothersome gastrointestinal effects are not associated with unregulated consumption of olestra corn chips and potato chips in the home.

Topics: triglycerides, food, signs and symptoms, digestive
Gail A. Greendale, MD; Beth A. Reboussin, PhD; Angela Sie, MD; H. Rosy Singh, MD; Linda K. Olson, MD; Olga Gatewood, MD; Lawrence W. Bassett, MD; Carol Wasilauskas, RN, MS; Trudy Bush, PhD; Elizabeth Barrett-Connor, MD, for the Postmenopausal Estrogen/Progestin Interventions (PEPI) Investigators*

Women receiving estrogen–progestin had an increased risk for having denser breasts on mammography compared with women who received conjugated equine estrogens only. This trial indicates that further study of the magnitude and meaning of increased mammographic density due to use of estrogen and estrogen–progestins is warranted because mammographic density may be a marker of risk for breast cancer.

Topics: progestins, estrogen, breast imaging reporting and data system, mammography
Jane A. Cauley, DrPH; Frances L. Lucas, PhD; Lewis H. Kuller, MD, DrPH; Katie Stone, PhD; Warren Browner, MD, MPH; Steven R. Cummings, MD, for the Study of Osteoporotic Fractures Research Group

Estradiol and testosterone levels may play important roles in the development of breast cancer in older women. A single measurement of bioavailable estradiol and free testosterone may be used to estimate a woman's risk for breast cancer.

Topics: testosterone, estradiol, hormone, breast cancer, gonadal steroid hormones
Janet W. Rich-Edwards, DSc; Graham A. Colditz, MBBS; Meir J. Stampfer, MD; Walter C. Willett, MD; Matthew W. Gillman, MD; Charles H. Hennekens, MD; Frank E. Speizer, MD; and JoAnn E. Manson, MD

Even after adjustment for adult body mass index and maternal history of diabetes, birthweight was found to be inversely associated with risk for type 2 diabetes during adulthood.

Topics: diabetes mellitus, type 2, birth weight
Jaime Aranda-Michel, MD; Alison Koehler, MD; Pablo A. Bejarano, MD; John E. Poulos, MD; Bruce A. Luxon, MD; Chaudhary Mobin Khan, MD; Looi C. Ee, MD; William F. Balistreri, MD; and Fredrick L. Weber Jr., MD

Liver failure occurred in three patients after they began receiving nefazodone. The temporal onset of disease after the start of this therapy suggests that it caused severe hepatocellular injury.

Topics: liver failure, nefazodone
Selim R. Benbadis, MD; Edward Mascha, MS; Michael C. Perry, R.EEG.T, RPSGT; Barbara R. Wolgamuth, R.EEG.T; Laurence A. Smolley, MD; and Dudley S. Dinner, MD

No statistically or clinically significant association was seen between scores on the subjective Epworth Sleepiness Scale and results of the objective mean sleep latency test. These tests may evaluate different, complementary aspects of sleepiness.

Topics: multiple sleep latency test, drowsiness, sleep
Cynthia W. Ko, MD; John H. Sekijima, MD; and Sum P. Lee, MD, PhD

Biliary sludge is a controversial entity related to gallstones. This paper reviews the chemical composition, pathogenesis, diagnosis, clinical course, complications, treatment, and prevention of biliary sludge.

Topics: biliary sludge, biliary calculi, sludge, physiological, bile fluid, cholesterol

Coccidioidomycosis is an increasingly important health problem because of the migration of large numbers of persons to portions of the endemic southwestern United States and the increasing numbers of immunosuppressed patients. This Update discusses the importance of early diagnosis, specific tests for diagnosis, management of newly diagnosed infections, use of specialists in a multidisciplinary approach to management, opportunities for research, and the need for reassessment of institutional policy.

Topics: coccidioidomycosis
Howard M. Spiro, MD

Sandler and colleagues' controlled study of the gastrointestinal effects of olestra highlights the intriguing role of placebos in clinical studies.

Topics: flatulence
David J.P. Barker, MD, PhD, FRS

In this issue, Rich-Edwards and colleagues report that low birthweight is related to development of type 2 diabetes. The mechanisms by which malnutrition and retarded growth in utero lead to lifelong changes in glucose and insulin metabolism need to be explored.

Topics: diabetes mellitus, type 2, fetus

Emerging findings of the benefit of tight glucose control in patients with type 2 diabetes have prompted the National Institutes of Health and the Centers for Disease Control and Prevention to sponsor a major national initiative, the National Diabetes Education Program. This program seeks to improve the treatment and outcomes of patients with diabetes, promote early detection, and, ultimately, prevent the onset of the disease.

Topics: diabetes mellitus, type 2, diabetes mellitus

Accompanying this issue is a supplement on the hospitalist movement. The articles in this supplement define the current manpower status of this movement, examine some of its early experiments, and offer the perspectives of some of internal medicine's thought leaders on the implications of what it all means for our specialty.

Topics: hospitalists
Clifton R. Lacy, MD; Maureen Bueno, RN, PhD; and John B. Kostis, MD
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Maureen A. Smith, MD, MPH; Eyal Shahar, MD, MPH; and Russell V. Luepker, MD, MS
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Stergios Kechagias, MD; Kjell-Å ke Jönsson, MD, PhD; and Alan Wayne Jones, PhD, DSc
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Debra H. Schussheim, MD; Thomas P. Jacobs, MD; and Shonni J. Silverberg, MD
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Antonio Montero; Adria G. Giovannoni; and Pablo L. Tvrde
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Brent A. Neuschwander-Tetri, MD; William L. Isley, MD; and Julie C. Oki, PharmD
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Topics: illiteracy
Topics: preventive medicine, influenza virus vaccine, vaccines, serum cholesterol measurement, mammography, pneumococcal vaccine, ...
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Jeanne Manson, PhD; and Michelle Berlin, MD, MPH
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Nancy W. Sobecks, MD; Amy C. Justice, MD, PhD; Susan Hinze, PhD; Heidi Taylor Chirayath, MA; Rebecca J. Lasek, PhD; Mary-Margaret Chren, MD; John Aucott, MD; Barbara Juknialis, MA; Richard Fortinsky, PhD; Stuart Youngner, MD; and C. Seth Landefeld, MD

Men and women in dual-doctor families differed from other physicians in many aspects of their professional and family lives, but they achieved their career and family goals as frequently.

Topics: income, family relationship, marriage, life event, child rearing, perception
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