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In This Issue of Archives of Internal Medicine
July 23, 2001

In This Issue of Archives of Internal Medicine

Arch Intern Med. 2001;161(14):1700. doi:10.1001/archinte.161.14.1700

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.

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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.

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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.

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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.

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