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2 January 2001 Annals of Internal Medicine Tip Sheet

Annals of Internal Medicine is published by the American College of Physicians-American Society of Internal Medicine (ACP-ASIM), an organization of more than 115,000 internal medicine physicians and medical students. The following highlights are not intended to substitute for articles as sources of information. For an embargoed fax of an article, call 1-800-523-1546, ext. 2656 or 215-351-2656. Full content of the issue is available on the Internet at on January 2, 2001.

Cheap, Effective, But Not Easy
Losing Weight Lowers High-Normal Blood Pressure

Blood pressure decreased in overweight adults with high-normal blood pressure who lost weight (Article, p. 1). A study compared two groups of overweight people with high-normal blood pressure, one in a weight loss program, the other not. The control group gained weight and did not achieve lower blood pressure. An editorial notes that only 13 percent of the participants in the weight loss group maintained substantial weight loss over the three-year study period and suggests steps to deal with the complex problem of obesity (Editorial, p. 72).

Symptoms Don’t Predict Presence of Initial HIV Infection

A study of 436 patients with signs of viral infection and risk factors for exposure to HIV infection examined the usefulness of symptoms and two diagnostic tests in accurately diagnosing primary HIV infection (Article, p. 25). No symptom or group of symptoms predicted primary HIV infection, and both of the diagnostic tests had limitations. An editorial says that diagnosis and treatment of HIV infection are still often left to specialists, which may severely interfere with the profession’s ability to diagnose this disease.

Scuba Divers At Risk for Brain Lesions

Scuba divers had more ischemic brain lesions, or damage to small parts of the brain, than a control group of nondivers, a study found (Article, p. 21). Divers who had a heart abnormality called a patent foramen ovale had a 4.5-fold increase in decompression illnesses and twice as many ischemic brain lesions as divers without the heart abnormality. It is not known whether the ischemic brain lesions associated with scuba diving affect brain function.

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