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6 March 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 16, 2001.

ACE Inhibitors Help Diabetic Patients Prevent Kidney Damage

Researchers found that angiotensin-converting enzyme (ACE) inhibitors (medications known to help prevent diabetes-related kidney failure) also worked to slow progression to kidney disease in certain diabetic patients with microalbuminuria, a condition in which small amounts of the protein albumin appear in the urine (Article, p. 370). ACE inhibitors are usually recommended for diabetes patients with a large amount of albumin in the urine, a sign of more severe kidney damage. This study shows that the inhibitors work even when only very small amounts of the protein are present. Furthermore, kidney function was three times more likely to become normal in patients who received ACE inhibitors than in those who did not.

Does Treating Helicobacter pylori Heal All Stomach Problems?

Successfully treating Helicobacter pylori (H. pylori) infection improved some precancerous conditions in the stomach, a new study found (Brief Communication, p. 380). In most of those patients whose long-term H. pylori was cured, stomach lining abnormalities improved.

Treating H. pylori infection did not improve upper stomach pain and discomfort (dyspepsia) not caused by ulcers or gastrointestinal reflux, another study found (Article, p. 361). When researchers looked at patients with both H. pylori infection and dyspepsia, those whose

H. pylori was treated did not differ from a group whose H. pylori infection was not treated, regardless of whether the infection was cured.

Land Mines Casualties: Mine Ban Treaty Is the Only Way to Cure This Disease

Antipersonnel land mines kill or injure more than 2,000 people each month, mostly in developing nations. Many victims die because they get no medical care. Others are permanently disabled because rehabilitation and prostheses are not available. An editorial in this issue of Annals of Internal Medicine says that efforts to fund mine removal are praiseworthy, but the prevention of land mine casualties is “the only way to cure this disease.”

The 1997 Mine Ban Treaty prohibits the production, stockpiling, transfer and use of antipersonnel land mines. Since the treaty, the number of mine-producing countries has dropped from 54 to 16, international trade in land mines has gone “from a flood to a trickle,” and land mine casualties have begun to decrease. To date, 139 nations have signed the Mine Ban Treaty but the United States has not. “Physicians must continue to embrace this politically neutral, public health approach to the problem, by urging the United States to join the nations that have signed or have ratified the treaty,” the authors say.

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