Table Of Content

Supplement to Volume 114 Numbers 1-12 AIMEAS 114(1-12)1-1070(1991) US ISSN 0003-4819 Annals of Internal Medicine Published Twice Monthly by the American College of Physicians Publication Policy Committee, Editorial Board American College of Physicians James O. Armitage, MD; Omaha John H. Holbrook, MD, Chairman John P. Atkinson, MD; St. Louis Elizabeth Barrett-Connor, MD Laurence H. Beck, MD; Danville John F. Burnum, MD Karl G. Blume, MD; Stanford Clifton R. Cleaveland, MD John D. Cantwell, MD; Atlanta Linda Hawes Clever, MD Patricia A. Gabow, MD; Denver Ian R. Hart, MD Thomas S. Inui, MD; Seattle Kenneth M. Ludmerer, MD Mark A. Kelley, MD; Philadelphia Peter O. Kohler, MD; Portland Editors Donald F. Leon, MD; Pittsburgh Editors Diane E. Meier, MD; New York Robert H. Fletcher, MD, and Ronald P. Messner, MD; Minneapolis Suzanne W. Fletcher, MD Richard K. Root, MD; San Francisco Laurence Z. Rubenstein, MD; Sepulveda Editors Emeriti Jeremy N. Ruskin, MD; Boston J. Russell Elkinton, MD, and Charles R. Shuman, MD; Philadelphia Edward J. Huth, MD Eari P. Steinberg, MD; Baltimore Tadataka Yamada, MD; Ann Arbor Associate Editors Elias Abrutyn, MD Circulation John L. Abruzzo, MD E. Victor Adlin, MD Tamara N. Staley, Manager Martin Black, MD Leonard E. Braitman, PhD Editorial Staff Paul E. Epstein, MD Steven N. Goodman, MD, PhD, MHS Production Editor Daniel G. Haller, MD Miranda J. Hughes Warren Laskey, MD Book Review Editor Manuscript Editors Edward J. Huth, MD Alison S. Browdie Sandra D. Plum Executive Editor Paul J. Wolfe Kathleen Case Managing Editor Information Specialist Pamela Fried Elizabeth Wolverton Business Staff Proofreader Director Charles A. O’Hay Thomas J. Gillen Advertising Office Manuscript Processing Supervisor Hal S. Bischoff, Sales Representative Lorraine Friedman Thomas A. Smith, Jr., Sales Representative Ara H. Eloian, Production Manager Annals of Internal Medicine * Volume 114 Il IV Annals of Internal Medicine * Volume 114 Annals of Internal Medicine 1 January 1991 Volume 114 Number 1 THE STATE OF INTERNAL MEDICINE—1991 Editorials, 88 Articles Internal Medicine—1991 How Satisfying Is the Practice of Internal Medicine? Lewis, Prout, Chalmers, Leake Fletcher, Fletcher Medical Student Interest in Internal Medicine 6 Schwartz, Linzer, and others The Future of Internal Medicine: Framing the Questions Medical Student Attitudes about Internal Medicine: 16 Babbott, Levey, Weaver, Thier A Study of U.S. Medical School Seniors in 1988 Killian A Perspective on Medical Student Education for Internal Medicine A National Study of AIDS and Residency Training: 23 Hayward, Shapiro Federman Experiences, Concerns, and Consequences Professionalism in Residency Changes in the Medical Knowledge of Candidates 33 Norcini, Shea, Benson Reynolds for Certification Internal Medicine: A View from National Study of Internal Medicine Manpower 36 Lyttle, Andersen, Neymarc, the Country XVIII: Subspecialty Fellowships with a Special Schmidt, Kohrman, Levey Loge Look at Hematology and Oncology, 1988-1989 Letters, 94 Parental Leave Policies for Faculty in U.S. 43 Grisso, Hansen, Zelling, Switching Phlebotomy Needles Medical Schools Bickei, Eisenberg Radiotherapy for Lung Cancer Nocturnal Hypertension in Diagnosis and Treatment Hemodialysis Patients Internists’ Practices in Health Promotion and 46 Schwartz, Lewis, Clancy, Metoprolol-Induced Polymyalgia- Disease Prevention Kinosian, Radany, Koplan Like Syndrome The Counseling Practices of Internists 54 Lewis, Clancy, and others Thyroid Hormones and Asthma Topical Tretinoin and Vaginal Position Papers Bleeding Time-Limited Certification and Recertification: 59 Glassock, Benson, Copeland, White Hand: Raynaud Phenomenon or Leprosy? The Program of the American Board of Internal Godwin, Johanson, Point, Medicine Popp, Scherr, Stein, Taunton Clinical Decision Analysis Promotion and Tenure of Women aii) Minorities 63 American College of The Bookie, the Girlfriend, and on Medical School Faculties Physicians the Vultures The Literature of Medicine, 99 Perspectives For complete contents, see pages I-3 and I-4 The Leadership Crisis in Internal Medicine: 69 Reitemeier What Can Be Done? Subspecialists and Internal Medicine: A Perspective 76 Braunwald AIMEAS 114(1)1-100(1991) US ISSN 0003-4819 Grand Cru versus Generic: Different Approaches 79 Stein to Altering the Ratio of General Internists to Subspecialists On Being a Doctor Just Beyond the Next Bend in the River: 83 McGuire Reflections on a Medical Career Annals of Internal Medicine * Volume 114 Vv Annals of Internal Medicine Volume 114 Number 2 15 January 1991 Letters, 166 Articles Screening for Colorectal Cancer Elimination of Coincident Staphylococcus aureus Reagan, Doebbeling, Pfaller, Calcium-Channel Antagonists Nasal and Hand Carriage with Intranasal Sheetz, Houston, Hollis, Reduce Renal Protein Excretion Application of Mupirocin Calcium Ointment Wenzel Caregiving in Alzheimer Dementia Methicillin-Resistant Staphylococcal Colonization Muder, Brennen, Wagener, Predicting Suicide and Infection in a Long-Term Care Facility Vickers, Rihs, and others Transference Health, Functional Status, and Employment of Wingard, Curbow, Baker, Adult Survivors of Bone Marrow Transplantation Piantadosi Medical Futility Population 2nd the Environment The Safety and Immunogenicity of a Human Dolin, Graham, Greenberg, Immunodeficiency Virus Type | (HIV-1) Tacket, Belshe, Midthun, Safety of Factor VIII Recombinant gp160 Candidate Vaccine in Humans Clements, Gorse, and others Hepatitis C Virus Infection in Hemophiliacs An Increase in Plasma Cholesterol Independent of Wiersinga, Trip, van Beeren, Thyroid Function during Long-Term Amiodarone Plomp, Oosting Clinical Prediction Rules Therapy Correction, 172 Outcome of Prophylactic Therapy for Idiopathic Wong, Yarnold, Yango, SI Units for Insulin Anaphylaxis Patterson, Harris The Literature of Medicine, 173 Which Clinical Variables Predict an Abnormal Zarchy, Ershoff For complete contents, see pages Double-Contrast Barium Enema Result? I-3 and I-4 Brief Reports Low-Probability Lung Scan Findings: A Need Hull, Raskob AIMEAS 114(2)101-176(1991) for Change US ISSN 0003-4819 Rapid Reversal of Acute Psychosis in the Cushing van der Lely, Foeken, Syndrome with the Cortisol-Receptor Antagonist van der Mast, Lamberts Mifepristone (RU 486) Corticosteroid Therapy for Diffuse Alveolar Chao, Duncan, Long, Horning, Hemorrhage in Autologous Bone Marrow Blume Transplant Recipients Review Caffeine and Cardiac Arrhythmias Myers Medicine and Public Issues Limiting Resuscitation: Emerging Policy in the Sachs, Miles, Levin Emergency Medical System Perspective Ethics Consultation: Skills, Roles, and Training La Puma, Schiedermayer Editorials AIDS Vaccines: Progress and Unmet Challenges Bolognesi Methicillin-Resistant Staphylococcus aureus: Do Haley We Just Have To Live with It? ACP Journal Club Fletcher, Fletcher VI Annals of Internal Medicine * Volume 114 Annals of Internal Medicine Volume 114 Number 3 1 February 1991 Letters, 248 Articles Treatment of Hyponatremia Colonoscopic Surveillance after Polypectomy: 177 Ransohoff, Lang, Kuo ACE Inhibitors for Scleroderma Considerations of Cost Effectiveness Renal Crisis Systemic Lupus Erythematosus after Renal 183 Nossent, Swaak, Berden, the Erythrocytosis after Zidovudine Transplantation: Patient and Graft Survival Dutch Working Party on for AIDS and Disease Activity Systemic Lupus Erythematosus Splenic Infarction after Cocaine Safety and Efficacy of Oral Flecainide Therapy 189 Cockrell, Scheinman, Titus, Use in Patients with Atrioventricular Re-entrant Heimy, Langberg, Lee, Griffin False-Positive Anti-HCV in Tachycardia Biliary Cirrhosis Failure of Ciprofloxacin to Eradicate Convalescent 195 Neill, Opal, Heelan, Giusti, Tuberculosis and HIV Infection Fecal Excretion after Acute Salmonellosis: Cassidy, White, Mayer in Kenya Outbreak in Health Care Workers HIV Infection after Needlesticks Omeprazole Enhances the Efficacy of Pancreatin 200 Heijerman, Lamers, Bakker Correction, 253 (Pancrease) in Cystic Fibrosis Acetaminophen Toxicity Echocardiographic Left Ventricular Mass and 202 de Simone, Devereux, Roman, The Literature of Medicine, 254 Electrolyte Intake Predict Arterial Hypertension Schlussel, Alderman, Laragh Brief Reports AIMEAS 114(3)177-256(1991) Barrett Esophagus after Chemotherapy with 210 Sartori, Nielsen, Indelli, US ISSN 0003-4819 Cyclophosphamide, Methotrexate, and Trevisani, Pazzi, Grandi 5-Fluorouracil (CMF): An Iatrogenic Injury? Primary Hepatocellular Carcinoma after 212 Luketic, Shiffman, McCall, Orthotopic Liver Transplantation for Chronic Posner, Mills, Carithers Hepatitis B Infection Hypertension Associated with Endothelin- 213 Yokokawa, Tahara, Kohno, Secreting Malignant Hemangioendothelioma Murakawa, and others Review Oral Corticosteroid Therapy for Patients with 216 Callahan, Dittus, Katz Stable Chronic Obstructive Pulmonary Disease Position Paper National Education Programs Working Group 224 Working Group on Management Report on the Management of Patients with of Patients with Hypertension Hypertension and High Blood Cholesterol and High Blood Cholesterol Medicine and Public Issues Certification and Recertification: One Approach to 238 Benson Professional Accountability Editorials Barrett Esophagus: A Sequela of Chemotherapy 243 Spechler Have You Ever Meta-Analysis You Didn’t Like? 244 Goodman Emergency Psychiatry: A Critical Educational 246 Weissberg Omission Annals of Internal Medicine + Volume 114 Vil Annals of Internal Medicine Volume 114 Number 4 15 February 1991 Letters, 335 Articles All Thumbs Up Nonsteroidal Anti-inflammatory Drug Use and Griffin, Piper, Daugherty, Predicting the Course of Increased Risk for Peptic Ulcer Disease in Snowden, Ray Unstable Angina Elderly Persons Osmolality Limitations of the Electrocardiogram in Estimating Christian, Clements, Low-Molecular-Weight Heparin Infarction Size after Acute Reperfusion Therapy Behrenbeck, Huber, Chesebro, and Venous Thrombosis for Myocardial Infarction Gersh, Gibbons Alpha-Interferon for the Thoracoscopy for the Diagnosis of Pleural Disease Menzies, Charbonneau Hypereosinophilic Syndrome Antibody to Hepatitis C Virus in Post-Transfusion Tremolada, Casarin, Tagger, Diagnosis of Fat Emboli Hepatitis Ribero, Realdi, Alberti, Ruol Effect of L-Thyroxine on Bone Mass Hepatitis C in Patients Undergoing Liver Read, Donegan, Lake, Ferrell, Transplantation Galbraith, and others Verapami! Toxicity—Treatment with Hemoperfusion Lymphoproliferative Responses to Borrelia Zoschke, Skemp, Defosse burgdorferi in Lyme Disease Labetalol Hepatotoxicity Rhabdomyolysis and Simvastatin The Munich Gallbladder Lithotripsy Study Sackmann, Pauletzki, Sauerbruch, and others Diarrhea after Misoprostol in Crohn Disease Brief Reports Chronic Pain Zidovudine-Induced Macular Edema Lalonde, Deschénes, Seamone Coccidia and Microsporidia The Adverse Effect Dilemma: Quest for Roush, McNutt, Gray Volume Index for Annals Accessible Information Ad Libitum, 344 Human Glue Diagnosis and Treatment Walking the Dog Diagnosing Pulmonary Embolism: New Facts Kelley, Carson, Palevsky, and Strategies Schwartz For complete contents, see pages I-3 and I-4 UCLA Conference Nonsteroidal Anti-inflammatory Drugs and Soll, Weinstein, Kurata, AIMEAS 114(4)257-344(1991) Peptic Ulcer Disease McCarthy US ISSN 0003-4819 The Literature of Medicine Access to Information about AIDS Veenstra, Gluck Medicine and Public Issues Delayed Access to Health Care: Risk Factors, Weissman, Stern, Fielding, Reasons, and Consequences Epstein Editorials Sepsis, the Sepsis Syndrome, Multi-Organ Bone Failure: A Plea for Comparable Definitions The Need to Educate Physician-Scholars for Swartz, Gottheil Leadership in the Health Care System VIII = Annals of Internal Medicine + Volume 114 Annals of Internal Medicine Volume 114 Number 5 1 March 1991 Clinical Prediction of Pneumonia —_R elation of Left Ventricular Mass and Geometry to 345 Koren, Devereux, Casale, GI Bleeding in Runners Morbidity and Mortality in Uncomplicated Savage, Laragh ‘RE te teeeaiiaail Essential Hypertension Glomerulonephritis Lack of Benefit of Methotrexate in Severe, 353 ~+Erzurum, Leff, Cochran, Drug Abuse and Stroke Steroid-Dependent Asthma Ackerson, Szefler, Martin, Cott Acetaminophen, INH, and Erythrocyte Sedimentation Rate Predicts Early 361 Henry-Amar, Friedman, Hepatic Toxicity Relapse and Survival in Early-Stage Hodgkin Hayat, Somers, Meerwaldt, Risk of Thoracentesis Disease Carde, Burgers, and others Colorectal Cancer: Heredity and AIDS Enteropathy: Occult Enteric Infections and 366 Greenson, Belitsos, Yardley, Environment Duodenal Mucosal Alterations in Chronic Diarrhea Bartlett Unnecessary Preoperative Tests: Increased Sympathetic Outflow in Cirrhosis and 373 ~+Floras, Legault, Morali, Hara, The Hospital’s Role Ascites: Direct Evidence from Intraneural Blendis Time-Limited Certification Recordings Corrections, 433 Do Life Events or Depression Exacerbate 381 North, Alpers, Helzer, Bone Density in Injured Inflammatory Bowel Disease? Spitznagel, Clouse Athletes The Acute Lupus Hemophagocytic Syndrome 387 Wong, Hui, Chan, Chan, Ha Confusion Assessment Method ‘ ‘ Brief Report Book Review . : : . The Literature of Medicine, 434 Atheromatosis of the Aortic Arch as an Occult 391 Tunick, Culliford, Lamparello, Source of Multiple Systemic Emboli Kronzon For complete contents, see pages I-3 and 1-4 Academia and Clinic Assessment of Clinical Skills of Residents Utilizing 393 Stillman, Swanson, Regan, Standardized Patients Philbin, Nelson, and others AIMEAS 114(5)345-436(1991) US ISSN 0003-4819 UCLA Conference Recombinant Human Erythropoietin and Renal 402 Nissenson, Nimer, Wolcott Anemia: Molecular Biology, Clinical Efficacy, and Nervous System Effects Perspective Streptokinase and Recombinant Tissue Plasminogen 417 Sherry, Marder Activator (rt-PA) Are Equally Effective in Treating Acute Myocardial Infarction Editorials Emerging Resistance to Fluoroquinolones in 424 Trucksis, Hooper, Wolfson Staphylococci: An Alert University Medical Center Participation in 426 Bogdonoff, Fins Residency Training Programs for Graduates of Foreign Medical Schools Annals of Internal Medicine + Volume 114 IX Annals of Internal Medicine Volume 114 Number 6 15 March 1991 Letters, 518 Articles The State of Internal Medicine Effect of Parenterally Administered Gold Therapy Epstein, Henke, Yelin, Katz Vitamin D for Osteoporosis on the Course of Adult Rheumatoid Arthritis Castleman Disease-POEMS Sulphasalazine and Prednisone Compared with Rijk, van Hogezand, van Lier, Syndrome Overlap Sulphasalazine for Treating Active Crohn Disease van Tongeren Thrombolytic Therapy Failure of Physicians To Recognize Functional Calkins, Rubenstein, Cleary, ‘*Seronegative’’ Syphilis in AIDS Disability in Ambulatory Patients Davies, Jette, and others Accuracy of Pelvic Pneumothorax in AIDS Sepkowitz, Telzak, Gold, Examination Bernard, and others Corrections, 522 Narrow QRS Ventricular Tachycardia Hayes, Stewart, Greene, Bardy Author’s Name Increased Plasma Endothelin-1 in Pulmonary Stewart, Levy, Cernacek, Streptokinase Meta-Analysis Hypertension: Marker or Mediator of Disease? Langleben The Literature of Medicine, 523 Brief Report For complete contents, see pages I-3 and I-5 Immunogenicity of an Inactivated Hepatitis A Sjogren, Hoke, Binn, Eckels, Vaccine Dubois, Lyde, and others Diagnosis and Treatment AIMEAS 114(6)437-524(1991) US ISSN 0003-4819 Lyme Disease: Recommendations for Diagnosis Rahn, Malawista and Treatment Academia and Clinic Teaching Medicine as a Human Experience: Branch, Arky, Woo, Stoeckle, A Patient-Doctor Relationship Course for Levy, Taylor Faculty and First-Year Medical Students Review Diagnosis of Lyme Disease Based on Malane, Grant-Kels, Feder, Dermatologic Manifestations Luger Davis Conference Sudden Cardiac Death: Management of Akhtar, Garan, Lehmann, High-Risk Patients Troup Editorials Adenosine or Verapamil for the Acute Treatment Rankin, McGovern of Supraventricular Tachycardia? Confidence Intervals Assess Both Clinical Braitman Significance and Statistical Significance xX Annals of Internal Medicine * Volume 114 Annals of Internal Medicine Volume 114 Number 7 1 April 1991 Brief Reports, 569 Articles era — <0 a Effect of Towne Live Virus Vaccine on 525 Plotkin, Starr, Friedman, Sees Hannan ovens Seay Cytomegalovirus Disease after Renal Transplant Brayman, Harris, and others Exacerbate Hypoxemia in High-Altitude Pulmonary Edema _[nterferon-Alpha Produces Sustained Cytogenetic 532 Talpaz, Kantarjian, Kurzrock, Levine and others Responses in Chronic Myelogenous Leukemia Trujillo, Gutterman ———re Propafenone Treatment of Symptomatic 539 Pritchett, McCarthy, Paroxysmal Supraventricular Arrhythmias Wilkinson itinagesacrniey Preevevnetniotni on oof fD eDeeepp VeiVne in ThrTohmrboomsboissi s afatf er 545 Leveinvei, ne, HiHirrsshh, ,G eGenntt,, TuTrupripi e, From the CFC Weekly Report Elective Hip Surgery Leclerc, Powers, Jay, Neemeh Letters, 603 : ; i i _ A Prognostic System for Transient Ischemia or 552 Kernan, Horwitz, Brass, Distal and Proximal Colon Minor Stroke Viscoli, Taylor Adenomas Cross-National Changes in the Effects of Peptic 558 Bloom ‘*Low-Probability”’ Ulcer Eilsenes Ventilation-Perfusion Scans Recreational Drug Use and Stroke Nasal Spray Desmopressin (DDAVP) for Mild 563 _—_—R ose, Aledort Hemophilia A and von Willebrand Disease AIDS and Residency Training lloprost for Scleroderma Diagnosis and Treatment Interferon Inhibitors Digoxin for Atrial Fibrillation: A Drug Whose $73 Falk, Leavitt Resource Center for Occupational Tirae Has Gone? and Environmental Medicine The Literature of Medicine, 60? Academia and Clinic For complete contents, see pages Physicians’ Information Needs: Analysis of 576 Osheroff, Forsythe, Buchanan, 1-3 and 1-5 Questions Posed during Clinical Teaching Bankowitz, Blumenfeld, Miller AIMEAS 114(7)525-612(1991) Review US ISSN 0003-4819 Infections in HIV-Infected Travelers: Risks and 582 Wilson, von Reyn, Fineberg Prevention NIH Conference Diagnosis and Management of Asymptomatic 593 Consensus Development Primary Hyperparathyroidism: Consensus Conference Panel Development Conference Statement Editorials Options for Prevention of Cytomegalovirus Disease 598 Balfour Unintended Pregnancy among Teenagers: 599 Fielding, Williams Important Roles for Primary Care Providers Annals of Internal Medicine + Volume 114 XI Annals of Internal Medicine Volume 114 Number 8 15 April 1991 Letters, 701 Articles Streptokinase for Inferior Effect of Antihypertensives on Sexual Function and Wassertheil-Smoller, Blaufox, Myocardial Infarction Quality of Life: The TAIM Study Oberman, Davis, and others Diagnosis of Pulmonary Embolism Quality-of-Life-Adjusted Evaluation of Adjuvant Gelber, Goldhirsch, Cavalli Predic:ing Bacteremia Therapies for Operable Breast Cancer Outcomes of Carotid Long-Term Remission of Chronic Hepatitis B after Korenman, Baker, Waggoner, Endarterectomy Alpha-Interferon Therapy Everhart, and others Corticosteroids for COPD Emboli in Infective Endocarditis: The Prognostic Steckelberg, Murphy, Ballard, MRSA in Perspective Value of Echocardiography Bailey, Tajik, and others Dexamethasone for Alcohol The Changing Prognosis of Classic Hemophilia Jones, Ratnoff Withdrawal (Factor VIII ‘‘Deficiency’’) Survey Research Comparison of Silent and Symptomatic Ischemia Miranda, Lehmann, Prevention: Where Do We Draw during Exercise Testing in Men Lachterman, and others the Line? ACP Journal Club Psychological and Behavioral Implications of Lerman, Trock, Rimer, Abnormal Mammograms Boyce, Jepson, Engstrom Journai Title Changes The Literature of Medicine, 708 Brief Reports For complete contents, see pages Long-Term Follow-up of Voluntary Ingestion of Morris, Ali, Nicholson, I-3 and I-5 Helicobacter pylori Perez-Perez, Blaser Cardiopulmonary Toxicity after Liposomal Levine, Walsh, Martinez, AIMEAS 114(8)613-712(1991) Amphotericin B Infusion Eichacker, and others US ISSN 0003-4819 Review Tolerance to Organic Nitrates: Evidence, Elkayam Mechanisms, Clinical Relevance, and Strategies for Prevention NIH Conference Immunopathogenic Mechanisms in Human Fauci, Schnittman, Poli, Immunodeficiency Virus (HIV) Infection Koenig, Pantaleo On Being a Doctor Heal Thyself Freeman Editorials The Quality of Life, Research, and Care Deyo Gene Therapy in Humans: A New Era Begins Kelley Early Release of Research Results Fletcher, Fletcher XII_—s Annals of Internal Medicine * Volume 114