May/June 2008 Annals of Family Medicine...(with each other as well as to include a ...),Health

Effect of Nonergot Dopamine Agonists on Symptoms of Restless Legs Syndrome
By William L. Baker, Pharm.D., et al

Kataoka and Matsuno describe the often benign nature of pulmonary crackles discontinuous, interrupted, explosive respiratory sounds heard during inspiration in many older patients. Examining a panel of 274 patients 45 to 95 years old, they found many had audible pulmonary crackles, even in the absence of apparent cardiac dysfunction and comorbid pulmonary disease. The older the age-group, the more frequently the patients had audible pulmonary crackles. In fact, the findings show that the risk for audible crackles increased approximately threefold every 10 years after 45 years of age in patients with cardiovascular disease and apparently normal heart function. They conclude that the recognition of age-related crackles is important, because such clinically unimportant crackles are so common among elderly patients that, without knowledge of this phenomenon, their existence might interfere with the physicians management of patients with suspected heart failure or presumable pulmonary disease.

Age-Related Pulmonary Crackles (Rales) in Asymptomatic Cardiovascular Patients
By Hajime Kataoka, M.D. and Osamu Matsuno, M.D.

An estimated 250 physicians will commit suicide this year. In this essay, a family physician shares her grief and guilt over the suicide of a colleague while reflecting on both the scale of this largely unacknowledged problem and the stigma that prevents the profession from adequately addressing it.

Today Im Grieving a Physician Suicide
By Jennifer L. Middleton, M.D., M.P.H.