Dysfunctional uterine bleeding is a common gynecologic disorder that can affect any woman during her reproductive years. It is a diagnosis of exclusion, and the clinician must proceed through a logical stepwise evaluation to rule out all other causes of the abnormal bleeding. In most cases dysfunctional uterine bleeding is associated with anovulation. During the pubertal and perimenopausal periods, anovulatory bleeding is a common occurrence. During these transitional states, the abnormal bleeding has a physiological basis and is secondary to an estrogen withdrawal. Anovulatory bleeding can also be associated with chronic anovulation. The chronic unopposed estrogen that characterizes this disorder causes a continuous proliferation of the endometrium; this can result in abnormal bleeding and place the patient at risk for endometrial cancer. The goals of treatment for anovulatory bleeding are to stop the acute bleeding, avert future episodes, and prevent long-term complications. In some cases surgical intervention is indicated, but the foundation of treatment has been a medical approach. Several progestational agents have demonstrated effectiveness and can be administered either orally or by intramuscular injection. If the patient fails to have resolution of the bleeding with medical therapy, another cause of the bleeding must be suspected, and reevaluation is necessary.

Seabather's eruption is usually a benign clinical syndrome that resolves spontaneously, although severe symptoms and long-term sequelae have been identified. Recent research has implicated the larvae of a jellyfish, Linuche unguiculata, as the cause of this syndrome; confirmation by serological and experimental studies is pending. Clinical signs and symptoms are consistent with this etiology. Outbreaks occur when jellyfish larvae are transported to shore by ocean currents. Treatment is symptomatic and involves use of antihistamines and steroids.

An allelic association between the TaqI "A" system A1 allele at the D2 dopamine receptor locus (DRD2) and either alcoholism or severe alcoholism has been proposed. Our purpose was to evaluate whether, based on all of the accumulated evidence, this association could be considered to be proven.

To assess the level of evidence for preventive health interventions for adults with human immunodeficiency virus (HIV) infection.

A two-part meta-analysis of studies examining the relationship of vitamin A supplementation and child mortality.

To determine whether it is safe to electively discontinue cyclosporine therapy after renal transplantation.

Pseudomembranous colitis associated with antibiotic therapy is almost always due to an overgrowth of Clostridium difficile. If untreated, pseudomembranous colitis can lead to severe diarrhea, hypovolemic shock, toxic dilatation of the colon, cecal perforation, hemorrhage, and death. However, C difficile-associated colitis can mimic the more common "benign" antibiotic-associated diarrhea that is not caused by C difficile. An algorithm for diagnosis management of hospitalized patients with antibiotic diarrhea and C difficile colitis is presented in this review. Diagnosis depends on sigmoidoscopy and/or stool tests for C difficile toxins in all patients with antibiotic-associated diarrhea. If the results of these tests are positive, either metronidazole or vancomycin is recommended for treatment of mild illness, and vancomycin is recommended for treatment of severe illness. Oral therapy is always preferred because it is more reliable. In patients with recurrent or relapsing colitis, treatment with either metronidazole or vancomycin is effective for that episode, but novel approaches, such as the oral or rectal introduction of competing nonpathogenic organisms, may prove to be more successful in prevention of relapses.

New definitions for sepsis and the systemic inflammatory response syndrome (SIRS) have been established. Comparatively little is known, however, about the types of patients who will be included within these new definitions.

To evaluate published reports of diagnostic methods for renovascular hypertension, including Doppler ultrasonography, magnetic resonance imaging, the captopril test, and captopril scanning.

Academic-industry relationships in the life sciences remain controversial. The available evidence suggests that such relationships have both benefits and risks for involved parties. Benefits include additional support of academic research, income for academic health centers, the potential for increased scientific and commercial productivity in both industries and universities, and enhancement of the educational experiences of students and fellows. Risks include an increase in secrecy in academic environments and damage to public support for the life science enterprise. The balance of known benefits and risks suggests that academic-industry relationships should be permitted and even selectively promoted. However, there is also a need for enhanced vigilance on the part of academic institutions and government to reduce risks posed by certain types of arrangements, especially those involving human subjects. Enhanced vigilance should include disclosure of all academic-industry relationships by life science faculty.

To assess the use of thrombolytic therapy for acute myocardial infarction, evaluating whether inclusion and exclusion criteria should be altered as well as the public health implications of any such alterations.

To estimate temporal trends in the rates of major depression cross-nationally.