et at http://www.acponline.org/journals/annals on March 1, 1998. * * *
Two Articles on Lyme Disease: Overtreatment Common; Not Associated With Heart Problems
A Lyme disease clinic studied 165 people with previous but not active Lyme disease or no evidence of current or previous infection. Researchers found that overdiagnosis and overtreatment were relatively common, and were associated with overuse of health resources, frequent minor drug reactions, disability and depression. (Article, p. 354.) Another study found that people with previously treated Lyme disease had no more heart problems than people with no history of the disease. (Article, p. 346.) * * *
'Realistic' Guidelines for Ethical Practice in Managed Care
Authors discuss practicing medicine ethically under the constraints of managed care. (Medicine and Public Issues, p. 395.) They offer physicians suggestions, such as not making incentive arrangements they would be embarrassed to describe accurately to their patients. * * *
Two Studies of Iron Overload: Often Undiagnosed and More Common Than Previously Thought
A study of body iron stores in 3,012 asymptomatic people found iron deficiency more common in women and iron overload more common in men. (Article p. 337.) Authors call for universal screening for hemochromatosis or iron overload, a genetic disease that can lead to organ damage and cirrhosis. They also say that iron-fortified food can do men more harm than good. Another study found that the diagnosis of iron overload was often missed in patients with diabetes, although iron overload is frequently associated with diabetes. (Brief Communication, p. 370.) These authors suggest screening high risk groups, such as patients with type 2 diabetes, for iron overload. * * *
Long-Term Therapy to Shrink Benign Thyroid Nodules Offers No Benefit
The majority of patients with benign thyroid nodules are best followed without thyroxine treatment, a review finds. (Review, p. 386.) Most benign nodules do not grow, and remain benign, the authors say. An editorial agrees and offers a strategy for treatment. (Editorial, p. 403.)
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