Writing a book about the history of anything is an ambitious undertaking, and this book is no different. For those of us who witnessed HIV from the beginning of its re-corded history, Engel does a good job of hitting the highlights and examining the issues.

Imagine yourself living with a chronic infection and-after trying your best to adhere to the recommended course of treatment-being told by your doctor: “You have failed your medication. The most we can do now is salvage therapy.

Much has been written about the increase in non–AIDS-defining cancers in HIV-infected persons over the past decade.

Cinti and colleagues1 call further attention to an increasing concern for people living with HIV infection and those providing their care: the increased risk of cancers that are not considered AIDS-defining events.

The first step in the workup of a patient with a persistent asymptomatic alkaline phosphatase (ALP) elevation is to measure gamma-glutamyltranspeptidase to determine whether the elevation is liver-related or bone-related.

Bipolar disorder (also known as manic-depressive illness) affects nearly 6 million adults in the United States.1 This psychiatric disorder was first described at the time of Hippocrates and is currently one of the most prevalent and severe mental illnesses in our society.

To help answer the question of Mary Ellen Lewis, PA-C, about her patient with a low-density lipoprotein (LDL) cholesterol level of 120 mg/dL and a high-density lipoprotein (HDL) cholesterol level of 100 mg/dL(CONSULTANT, June 2007), I would like to describe my approach to the treatment of dyslipidemia.

Nephropathy develops in about 30% of patients with diabetes. Screen for albuminuria at the time type 2 diabetes is diagnosed and within 5 years of diagnosis of type 1 diabetes.

About 25% of patients seek advice on exercise and physical activity from their physician, according to a recent survey conducted by the American College of Sports Medicine (ACSM). The survey also showed that about 65% of patients would be more interested in exercising to stay healthy if their physician offered recommendations and resources.

Sponsors of Part D plans are pressuring the Centers for Medicare & Medicaid Services (CMS) to shift its stand on e-prescribing, from encouraging physicians to voluntarily adopt the practice to mandating that they adopt it. "The time is now to require e-prescribing in Medicare. The only realistic way to rapidly accelerate adoption of e-prescribing is to require physicians to use the technology in Medicare," according to a statement released by the Pharmaceutical Care Management Association (PCMA). However, the AMA opposes such a mandate unless it includes federal grants or tax credits to help physicians pay for the necessary technology.

Currently, an estimated 20% of the adult US population have irritable bowel syndrome (IBS). Although the disorder affects both sexes, between 60% and 75% of persons who receive a diagnosis of IBS are women. IBS develops before age 35 in approximately 50% of those with the disorder. Between 5% and 20% of children and 6% to 14% of adolescents have symptoms of IBS.

Employers in general are highly satisfied with their PBMs. Employers gave PBMs an average overall service and performance rating of 7.9 on a 10-point scale compared with 7.8 in 2006.

Regular exercise increases cardiorespiratory endurance, tolerance to physical exertion, high-density lipoprotein cholesterol levels, and insulin sensitivity while decreasing adiposity, blood pressure levels, triglyceride levels, and inflammatory markers.1 All of this is probably common knowledge, but it also seems that consistent exercise may reduce the risk of Alzheimer disease (AD) and other types of dementia. This conclusion rests on evidence accumulating from 3 perspectives: observational studies, randomized clinical trials, and animal studies.

Adherence is a complex behavioral process strongly influenced by environmental factors. Six posters designed to improve medication adherence were displayed in a medical clinic, with each poster displayed for 1 month. These posters were seen by clinic patients but, as passive measures, required no additional time on the part of clinicians. Medication adherence to antidepressant therapy was assessed for two 18-month periods. Days of therapy and median gap (the number of days a patient goes without medication before filling the next prescription) were similar between the periods. Medication possession ratio (MPR) was increased in the intervention period (0.974 vs 0.994 days). During the 6-month period that the adherence posters were displayed, persistence decreased by only 10% (versus 22% for the nonintervention period). Use of passive measures may improve patient medication adherence. In this prospective study, both the MPR and persistence were improved. (Drug Benefit Trends. 2008:20:17-24)

Use of the antibiotic rifapentine was found to significantly shorten duration of treatment for tuberculosis (TB) in an animal study led by Eric L. Nuermberger, MD, assistant professor, Center for Tuberculosis Research at Johns Hopkins University School of Medicine, Baltimore. The study, published online December 17 in PLoS Medicine, was funded by the National Institute of Allergy and Infectious Diseases.

Premenopausal women with major depressive disorder (MDD) have less bone mineral density (BMD) than those without MDD, according to findings of a study published in the November 26 issue of Archives of Internal Medicine. Researchers reported that the level of bone loss in premenopausal women with MDD was at least as high as that associated with recognized risk factors for osteoporosis. The study was funded by the National Institute of Mental Health, the National Institute of Diabetes and Digestive and Kidney Diseases, the National Center for Complementary and Alternative Medicine, and the Warren Magnuson Clinical Center of the NIH.

Although the hospitalist model is rapidly altering inpatient care-an estimated 29% of American hospitals have hospitalists on staff and more than 12,000 hospitalists practice in the United States-little information about the clinical and economic outcomes of care by hospitalists is available.

In the November issue of Drug Benefit Trends, a Viewpoint titled "How Can We Improve Drug Safety?" and an Editorial titled, "Is the Time Right for a BTC Drug Class?" seemed to send mixed signals about whether there should be a third category of medications stocked behind the counter (BTC) for which pharmacists would provide counseling.

More than 600,000 cases of venous thromboembolism (VTE) occur annually in the United States.1 Appropriate use of prophylaxis in patients with risk factors for VTE and prompt treatment of those with evidence of VTE are essential to reduce the substantial morbidity, mortality, and costs associated with this common and potentially life threatening disorder.2,3

Systemic antibiotics are the mainstay of the managementof acute exacerbations of bronchiectasis. Antibiotic selection should include coverage for Streptococcus pneumoniaeand Haemophilus influenzae; particular attention alsoshould be paid to the presence of Staphylococcus aureus andPseudomonas species. There is some evidence that long-termlow-dose macrolide therapy can reduce the incidence of acuteexacerbations and decrease sputum production. There alsomay be a role for the use of inhaled antibiotics in the treatmentof bronchiectasis. Airway clearance strategies, such as chestpercussion and postural drainage, are clearly useful in patientswith cystic fibrosis and may be useful in managing bronchiectasisin other patients. Surgical resection can be considered if apatient has localized disease that is refractory to medical managementor if he or she is unwilling to undergo long-term medicaltherapy. (J Respir Dis. 2008;29(1):20-25)