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2 October 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.

Some Women on HRT May Be at Increased Risk for Gallbladder Surgery

Researchers studied data on 2253 women with heart disease who had been randomly assigned to take hormone replacement therapy (HRT) or placebo (Article, p.493). Of the 147 women who had gallbladder surgery, those who took HRT, consisting of estrogen plus progestin, were 40 percent more likely than women taking placebo to require gallbladder surgery. For every 185 women taking HRT, one additional woman required gallbladder surgery. Other factors such as obesity were more important factors in predicting gallbladder disease that required surgery.

Anti-Cancer Drug May Treat Aplastic Anemia

Researchers treated 19 patients with severe aplastic anemia with high doses of the anti-cancer drug cyclophosphamide (Article, p. 477). In aplastic anemia, antibodies destroy the bone marrow's ability to make cells. The best treatment for the hard-to-treat and often fatal disease is bone marrow transplantation, but not all patients can have this procedure. High-dose cyclophosphamide was successful in treating some aplastic anemia patients. The researchers say that the small, uncontrolled study "provides strong justification for a multicenter, randomized, controlled trial," and, if high-dose cyclophosphamide proves to generate durable, complete remission in aplastic anemia, the drug has "broad implications for the treatment of many severe autoimmune diseases." An editorial cautions that at this time, cyclophosphamide should still be considered an experimental approach for the initial management of aplastic anemia (Editorial, p. 524).

Six Principles to Safeguard Adults Unable to Consent to Participate in Clinical Research

(Medicine and Public Issues, p. 514.)

The Subjective Side of Scientific Reasoning Is Revealed by Conventional Medicine's Reaction to Homeopathy

(Academia and Clinic, p. 507.)

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