Prophylaxis against Mycobacterium avium complex infection can safely be withdrawn or withheld in adults with HIV infection whose CD4+ cell count increases during antiretroviral therapy.

Some patients with ovarian cancer seem to have good outcomes after autotransplantation, although several biases may have affected these observations. Phase III trials are needed to compare outcomes after autotransplantation with outcomes after conventional chemotherapy.

In healthy older adults, low-dose hydrochlorothiazide preserves bone mineral density at the hip and spine. If the modest effects observed over 3 years are accumulated over 10 to 20 years, they may explain the one-third reduction in risk for hip fracture associated with thiazide in many epidemiologic studies.

Requests for euthanasia and physician-assisted suicide are likely to decrease as training in end-of-life care improves and the ability of physicians to provide this care to their patients is enhanced.

Meal ingestion and head-up tilt-table testing are associated with increasing occurrences of symptomatic hypotension; 22% of functionally independent elderly persons in this study had symptomatic hypotension after eating a meal and undergoing tilt-table testing.

Levels of smooth-muscle myosin heavy-chain protein can be used to diagnose aortic dissection soon after symptom onset. This assay had the greatest diagnostic value in patients with proximal lesions.

The robust findings of trials examining lipid-lowering drug therapy do not necessarily justify targeting low-density lipoprotein cholesterol to its lowest possible level, and the argument expressed by the phrase “the lower the better” is clearly not evidence based.

In this issue, Stiff and colleagues report on the use of autologous stem-cell transplantation in patients with ovarian cancer. To determine the role of this therapy, the available data must be compared with data from other treatment strategies in similar patients. This editorial compares “best-case scenario” data on several approaches.

The sign on the front door reads: Practitioner of the Alternative, Healing Arts. Rugs, curtains, and a fireplace in the corner warmed me. A friendly nurse escorted me to an examination room.

Augusto and Michaela Odone (Nick Nolte and Susan Sarandon) resolve to learn all they can about their son's illness. Lorenzo's Oil provides a case worth examining not only for its own story but also for what it reveals about a movie's ability to work on many levels at once and thereby transcend its own particularities to illuminate wider aspects of medical and cultural realities.

This Update addresses several of the ongoing debates in the gastroenterology literature. Topics discussed include esophageal disorders, acid peptic disorders, gastrointestinal effects of cyclooxygenase-2 inhibitors, and hepatobiliary disease.