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Bruce R. Bacon, MD; John K. Olynyk, MD; Elizabeth M. Brunt, MD; Robert S. Britton, PhD; and Roger K. Wolff, PhD

In this study, all patients homozygous for the C282Y mutation of HFE had an elevated hepatic iron concentration, but approximately 15% of these patients did not meet a previous diagnostic criterion for hemochromatosis. Determination of HFE genotype is clinically useful in patients with liver disease and suspected iron overload and may lead to identification of otherwise unsuspected C282Y homozygotes.

Topics: hemochromatosis, iron, liver diseases, genotype, heterozygote, homozygote
Alberto Ascherio, MD, DrPH; Eric B. Rimm, ScD; Miguel A. Hernán, MD, MPH; Edward Giovannucci, MD, ScD; Ichiro Kawachi, MD, DrPH; Meir J. Stampfer, MD, DrPH; and Walter C. Willett, MD, DrPH

Vitamin E and vitamin C supplements and specific carotenoids did not seem to cause a substantially reduced risk for stroke in a cohort of 40- to 75-year-old men who did not have a history of cardiovascular disease or diabetes.

Topics: vitamin e, ischemic stroke, carotenoids, ascorbic acid, stroke risk, cerebrovascular accident, diet ...
Robert M. Jasmer, MD; Judith A. Hahn, MA; Peter M. Small, MD; Charles L. Daley, MD; Marcel A. Behr, MD, MSc; Andrew R. Moss, PhD; Jennifer M. Creasman, MSPH; Gisela F. Schecter, MD, MPH; E. Antonio Paz, MD; and Philip C. Hopewell, MD

During a 6-year period in San Francisco, the rates of tuberculosis cases and clustered tuberculosis cases decreased both overall and among persons in high-risk groups. This occurred in a period during which tuberculosis control measures were intensified.

Topics: tuberculosis
Barbara J. Turner, MD, MSEd; Craig J. Newschaffer, PhD; Daozhi Zhang, MS; Thomas Fanning, PhD; and Walter W. Hauck, PhD

The success of Pediatric AIDS Clinical Trials Group 076 in preventing vertical HIV transmission prompted intensive efforts to inform lay persons and professionals about the trial's results. Community practices responded rapidly to efforts to disseminate these results. However, the absolute increase in prescribed therapy was greatest for women who had adequate prenatal visits or were receiving HIV-focused care, care at a site that conducted clinical trials, or methadone therapy.

Topics: pregnancy, hiv, acquired immunodeficiency syndrome, anti-retroviral agents, translating
Uggi Agnarsson, MD; Gudmundur Thorgeirsson, MD, PhD; Helgi Sigvaldason, PhD; and Nikulas Sigfusson, MD, PhD

Middle-aged men who participate in leisure-time physical activity and have good pulmonary function seem to have a lower risk for stroke than men who are not active or have diminished pulmonary function.

Topics: physical activity, respiration, ischemic stroke, stroke risk, cerebrovascular accident
Miquel Ferrer, MD; Torsten Thomas Bauer, MD; Antoni Torres, MD, PhD; Carmen Hernández, RN; and Carlos Piera, PhD

Small-bore nasogastric tubes in intubated patients did not reduce the rate of gastroesophageal reflux or microaspiration.

Topics: gastroesophageal reflux disease, nasogastric tube

An important problem exists in the interpretation of modern medical research data: Biological understanding and previous research play little formal role in the interpretation of quantitative results. The first of a pair of articles on evidence-based statistics outlines how the standard statistical approach has created this situation by promoting the illusion that conclusions that have certain “error rates” can be produced without consideration of information from outside the experiment.

Topics: medical research, inference, false-positive results

The second article on evidence-based statistics explores the inductive Bayesian approach to measuring evidence and combining information and addresses the epistemologic uncertainties that affect all statistical approaches to inference.

Topics: inference, standard error, calculi, sound, migraine disorders, likelihood ratio, bayesian analysis, decision ...

The number of physician-scientists, who study the pathogenesis of disease by using both bedside observations and modern laboratory techniques, is decreasing. This paper discusses the continuing need for physician-scientists and introduces a new professional organization, the Association for Patient-Oriented Research.

Topics: respiration, genetics, molecular, inspiration, atrophy, biological sciences, delivery of health care, united ...
Adele L. Franks, MD; and Wylie Burke, MD, PhD

The recent identification of two HFE gene mutations associated with hereditary hemochromatosis raised hope that genotyping could resolve the diagnostic uncertainty in early stages of the disease. In this issue, Bacon and colleagues explore the utility of genetic testing in referral patients with known or suspected hereditary hemochromatosis and other liver diseases. What implications do the results of this research have for the use of genetic testing during routine evaluation for hereditary hemochromatosis?

Topics: hemochromatosis

In this issue, Goodman demonstrates how the standard statistical methods used to analyze biomedical research, which we have come to accept as a kind of revealed truth, stand statistical inference on its head.

Topics: likelihood ratio, reasoning, inference, laboratory test finding, pretest probability of disease
Timothy E. Quill, MD

What can near-death experiences teach the physicians who care for dying patients?

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Thomas V. Nowak, MD

“Of all the medicines your mother takes,” Dr. Gorman said, “the morphine is the most important. … The point is, there just isn't any need for her to feel pain.”

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Adriano Alatri, MD; Paolo Bucciarelli, MD; and Marco Moia, MD
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Moses S. Elisaf, MD; Haralampos J. Millionis, MD; and Kostas C. Siamopoulos, MSc, MD
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Leonardo A. Sechi, MD; Laura Zingaro, MD; and Ettore Bartoli, MD
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Harold W. Horowitz, MD; Maria E. Aguero-Rosenfeld, MD; and Gary P. Wormser, MD
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Omaya H. Youssef, BSc, MSC, USAR; Almond J. Drake III, MD, MC, USN; and K.M. Mohamed Shakir, MD, MC, USN
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Kenneth D. Gardner Jr., MD
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Topics: ethanol, diet, cereals, food, sodium chloride, food industry, science of nutrition
Francie Scott
Topics: oxygen, travel
Michael B. Steinberg, MD, MPH
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Sheldon L. Brownstein, MD
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John D. Loeser, MD
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