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Jesper Lagergren, MD, PhD; Reinhold Bergström, PhD; Hans-Olov Adami, MD, PhD; and Olof Nyrén, MD, PhD

The use of lower esophageal sphincter–relaxing medications was associated with increased risk for esophageal adenocarcinoma.

Topics: esophageal adenocarcinoma, esophageal sphincter, lower, gastroesophageal reflux disease, gastric cardia adenocarcinoma, squamous ...
  
Tom Forsén, MD; Johan Eriksson, MD; Jaakko Tuomilehto, MD; Antti Reunanen, MD; Clive Osmond, PhD; and David Barker, FRS

The study findings are consistent with the hypothesis that type 2 diabetes is programmed in utero in association with low rates of fetal growth. The increased risk for type 2 diabetes related to small size at birth is further increased by high growth rates after 7 years of age.

Topics: diabetes mellitus, type 2, fetus, birth
  
Noriyuki Nakanishi, MD, DrPH; Koji Nakamura, MD, DrPH; Yoshio Matsuo, MD; Kenji Suzuki, ScD; and Kozo Tatara, MD

The number of cigarettes smoked daily and the number of pack-years of exposure seemed to be associated with development of impaired fasting glucose and type 2 diabetes in middle-aged Japanese men.

Topics: diabetes mellitus, type 2, impaired fasting glucose, smoking, diabetes mellitus
  
Kirk D. Miller, MD; Miriam Cameron, MD; Lauren V. Wood, MD; Marinos C. Dalakas, MD; and Joseph A. Kovacs, MD

Four patients receiving stavudine developed hepatic steatosis, lactic acidosis, and myopathy. Because hepatic steatosis may be life-threatening, physicians should consider it as a possible cause of elevated hepatic aminotransferase levels among patients taking stavudine.

Topics: fatty liver, acidosis, lactic, stavudine
  
Paul J. Jenkins, MD, MRCP; S. Aslam Sohaib, MRCP, FRCR; Scott Akker, MRCP; Rachel R. Phillips, MRCP, FRCR; Kate Spillane, MRCP; John A.H. Wass, MD, FRCP; John P. Monson, MD, FRCP; Ashley B. Grossman, MD, FRCP; G. Michael Besser, MD, FRCP, DSc; and Rodney H. Reznek, FRCR, FRCP

The predominant pathology of median neuropathy in acromegaly seems to be increased edema of the median nerve within the carpal tunnel rather than extrinsic compression from increased volume of the carpal tunnel contents.

Topics: acromegaly, median neuropathy
  
Stephen I. Wasserman, MD; Harry R. Kimball, MD; F. Daniel Duffy, MD, Task Force on Recertification*

In 2000, the American Board of Internal Medicine introduced a second-generation recertification process that builds on the current knowledge-centered program by adding assessments of clinical and communication skills, clinical performance, and medical outcomes.

Topics: internal medicine
  
Scott Burris, JD; Peter Lurie, MD, MPH; Daniel Abrahamson, JD; and Josiah D. Rich, MD, MPH

Physicians and pharmacists can play an important role in providing syringe access by prescribing and dispensing syringes to patients who use injection drugs and cannot or will not enter drug treatment.

Topics: syringes, hiv infection, prescribing behavior, intravenous drug user, pharmacist
  

In this issue, Lagergren and colleagues report that long-term use of drugs that promote lower esophageal sphincter relaxation may be responsible for about 10% of esophageal carcinomas. Although this study sheds light on a potential risk factor for esophageal carcinoma, further sound epidemiologic work is necessary.

Topics: gastroesophageal reflux disease, burning sensation
  

Three recent changes to the Uniform Requirements for Manuscripts Submitted to Biomedical Journals deserve special mention: use of the concepts of race and ethnicity, authorship issues, and use of reporting guidelines for specific study designs.

Topics: languages, guidelines, racial group, ethnic group
  
Muhammad Asim Khan, MD, FRCP

A physician reflects on his experience as a patient with complex, crippling illness for the past 44 years.

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Athanasios Katsarkas, MSc, MD, FRCS
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David P. Steensma, MD
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Conscientious physicians wishing to keep up to date with relevant information face a truly daunting task. Efforts to respond to this need are not new. More than two centuries ago, the first English-language journal of abstracts of books relevant to busy clinicians was published.

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David H. Spodick, MD, DSc
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Beatriz M. Rodriguez, MD
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Alicia Montañez, MD
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Topics: esophageal cancer, esophageal carcinoma
  
Topics: diabetes mellitus, type 2, birth
  
Topics: smoking, diabetes mellitus, type 2
  
Topics: hiv, metabolism, stavudine, liver
  
Topics: acromegaly, carpal tunnel syndrome
  
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Keith Roach, MD; Scott Stern, MD; Diane Altkorn, MD; Adam Cifu, MD; and Wendy Levinson, MD

This Update covers articles on several topics relevant to general internal medicine, including osteoporosis, venous thromboembolism, cardiovascular protection, and influenza.

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