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Annals of Internal Medicine is published by the American College of Physicians. These highlights are not intended to substitute for articles as sources of information. For an embargoed copy of an article, call 1-800-523-1546, ext. 2656, or 215-351-2656. Leave fax or e-mail and article topics.
A study of 210 adults traveling in Mexico, randomly assigned to take an antibiotic drug, rifaximin, or a placebo, found that those who took the drug had less mild diarrhea (14.7 percent) than those who received the placebo (53.7 percent) (Article, p. 805). Rifizimin has recently been approved in the United States for treatment of diarrhea. An editorial writer gives four reasons why the drug should not be prescribed as diarrhea prevention for all 50 million U. S. travelers (Editorial, p. 861). The drug can be a good alternative for selected patients, the writer says, but "rapid and judicious treatment of diarrhea, not antibiotic prophylaxis, is the best recommendation for most travelers."
Updated recommendations from the U.S. Preventive Services Task Force now recommend against routine use of estrogen alone to prevent chronic disease in postmenopausal women who have undergone hysterectomy (Guidelines, p. 855). The 2002 recommendations found insufficient evidence to recommend for or against routine use of estrogen alone to prevent chronic conditions in such women. The new guidelines for postmenopausal women recommend against routine use of combined estrogen and progestin for the sole use of preventing chronic conditions.
An analysis of data on 2,763 postmenopausal women with established coronary heart disease finds that women with slightly elevated blood sugar levels (impaired fasting glucose levels of 5.6 to 6.9 mmol/L) do not have increased risk for CHD (Article, p. 813).
(Article, p. 821; Editorial, p. 863).