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In This Issue of Archives of Internal Medicine
Arch Intern Med. 2001;161:1700.
Pneumococcal Peritonitis in Adult Patients: Report of 64 Cases With
Special Reference to Emergence of Antibiotic Resistance
Capdevila et al studied 64 adult patients with
pneumococcal peritonitis and found that primary pneumococcal peritonitis in
patients with cirrhosis more often spread hematogenously from the respiratory
tract and was associated with early mortality.
Secondary pneumococcal peritonitis may occur as a consequence of a transient
gastrointestinal tract colonization or inoculation during surgery.
Current levels of penicillin and cephalosporin resistance were not associated
with increased mortality rates.
(SEE ARTICLE)
Outcome of Adult Cardiopulmonary Resuscitations at a Tertiary Referral
Center Including Results of "Limited" Resuscitations
Dumot and colleagues studied 445 adult cardiac
resuscitations in a large tertiary referral hospital and found that 23% of
these patients survived to be discharged. Survival was highest (30%) for patients
with primarily cardiac disease, followed by patients with infectious diseases
(15%), but only 8% of patients with end-stage diseases survived until discharge.
(SEE ARTICLE)
A Prospective Study of Physical Activity and Cognitive
Decline in Elderly Women: Women Who Walk
Several studies have suggested that physical activity is positively
associated with cognitive function in elderly individuals; however, evidence
about this association has been limited by the cross-sectional design of most
studies and by the frequent lack of adjustment for potential confounding variables.
In this study, Yaffe et al determined whether physical
activity is associated with cognitive decline in a prospective study of 5925
older community-dwelling women who were without baseline cognitive impairment
or physical limitations. They found that women with greater baseline physical
activity (measured by blocks walked or total kilocalories expended per week)
were less likely to experience cognitive decline over the 8 years of follow-up,
even after multivariate adjustment. This finding supports the hypothesis that
physical activity prevents cognitive decline in older community-dwelling women.
(SEE ARTICLE)
The Effect of Hormone Replacement Therapy on Cardiovascular Risk Factors
in Type 2 Diabetes: A Randomized Controlled Trial
Combined continuous hormone replacement therapy (HRT) is associated
with improvements in serum lipoprotein levels in nondiabetic women; however,
the effect in women with diabetes has not been determined. This study by Manning et al evaluates the effect of combined continuous
HRT on lipoprotein and coagulation factor concentrations, and on glycemic
control in postmenopausal women with type 2 diabetes. In this randomized controlled
crossover study, 61 postmenopausal women with type 2 diabetes received 6 months
of treatment with combined continuous HRT or placebo. The concentrations of
total and low-density lipoprotein cholesterol decreased significantly during
treatment with HRT. There were no changes in high-density lipoprotein (HDL)
concentrations, its subfractions, or triglycerides. Lipoprotein, fibrinogen,
and fructosamine concentrations were reduced with HRT. In postmenopausal women
with type 2 diabetes, combined continuous HRT has beneficial effects on lipoprotein
concentrations and improves some markers of coagulation and glycemic control.
(SEE ARTICLE)
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