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Hannele Yki-Järvinen, MD; Leena Ryysy, MD; Kati Nikkilä, MD; Timo Tulokas, MD; Raimo Vanamo, MD; and Marjatta Heikkilä, RN

Combination therapy with bedtime insulin plus metformin prevents weight gain in patients with type 2 diabetes. This regimen also seems superior to other bedtime insulin regimens with respect to improvement in hyperglycemia control and frequency of hypoglycemia.

Topics: diabetes mellitus, type 2, insulin, metformin, glyburide, hypoglycemic agents

For elderly persons with chronic lung disease, influenza is associated with significant adverse health effects and influenza vaccine is associated with substantial health benefits. Among these benefits are fewer outpatient visits, fewer hospitalizations, and fewer deaths.

Topics: influenza, lung disease, chronic, hospitalization, influenza virus vaccine, outpatients, elderly, influenza with ...
Venkatarama K. Rao, MD, PhD; Elizabeth P. Iademarco, RN, MPH; Victoria J. Fraser, MD; and Marin H. Kollef, MD

In this study, delays in initiation of tuberculosis treatment were more common than delays in the initial suspicion of tuberculosis. Both types of delays were common even in patients with disease confirmed by a positive smear.

Topics: tuberculosis

Short-term treatment with alprostadil-α-cyclodextrine provides patients with critical leg ischemia a clinically worthwhile benefit that is apparent in the short term but decreases over time.

Topics: prostaglandins, ischemia, alprostadil, leg
Erica Daina, MD; Arrigo Schieppati, MD; and Giuseppe Remuzzi, MD

Mycophenate mofetil may be an alternative to steroids and cytotoxic agents in patients with Takayasu arteritis.

Topics: mycophenolate mofetil, takayasu's arteritis
Catherine A. Pesek, DO; Ryan Cooley, MD; Krzysztof Narkiewicz, MD, PhD; Mark Dyken, MD; Neal L. Weintraub, MD; and Virend K. Somers, MD, PhD

Theophylline may be a rapid and effective therapy for life-threatening Cheyne–Stokes respiration.

Topics: cheyne-stokes respiration, theophylline, oxygen
Weerapan Khovidhunkit, MD; and Dolores M. Shoback, MD

Raloxifene has been shown to have beneficial effects in selected organs in postmenopausal women. Although estrogen remains the drug of choice for hormonal therapy in most postmenopausal women, raloxifene may be an alternative in certain groups of women who have contraindications to estrogen and are at risk for osteoporosis.

Topics: estrogen, raloxifene

The study by Yki-Järvinen and colleagues in this issue adds to the accumulating data supporting the idea that intensive therapy goals can be achieved in patients with type 2 diabetes, with relatively low risk for hypoglycemia or weight gain. This growing body of evidence shows that laissez-faire therapy for type 2 diabetes is no longer acceptable.

Topics: diabetes mellitus, type 2
Robert M. Schainfeld, DO; and Jeffrey M. Isner, MD

Prognosis for patients with critical leg ischemia is often poor, and no pharmacotherapy has been effective. In this issue, the ICAI Study Group reports that prostaglandin E1 used to treat this condition had initial benefits that disappeared with time. Another potential medical approach to critical leg ischemia that has shown early promise is the use of gene transfer to repair the vascular system.

Topics: limb ischemia, ischemia
Michael A. LaCombe, MD

What is responsible for the despair and guilt, reflected in Costigan's essay in this issue, felt by young physicians who witness a patient's death after presumably missing a diagnosis?

Topics: forgiveness
David J. Costigan, MD

Maybe there are some experiences that you just cannot, and maybe should not, bury.

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Irvin S. Bauer

I wet my bed. That's how it all starts.

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Herbert S. Diamond, MD; and Elliot Goldberg, MD
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Tarik Asselah, MD; Jacques Bernuau, MD; and Patrick Marcellin, MD
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Patrice Cacoub, MD; Philippe Halfon, MD; and Lucile Musset, PhD
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Osamu Kabutomori, BSc; Yoshinori Iwatani, MD; and Miwako Kabutomori, BSc
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Leigh F. Callahan, PhD; and Theodore Pincus, MD
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This paper describes the rationale for continued attention to preventive care guidelines, the recent effort to organize existing guidelines, currently available compendiums of guidelines, ways to judge the quality of guidelines, and uses of guidelines in daily practice.

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Grant Gwinup, MD; and Dayna Diven, MD
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