Hearing and age: research challenges and the National Institute on Aging.

Just as the ear trumpet once symbolized the elderly, so do contemporary approaches to hearing loss in the aged reflect many of the major themes in geriatrics and gerontology today. This paper begins by describing the National Institute on Aging (NIA) with particular emphasis on activities relevant to hearing in the elderly. Next, several areas of research interest, including the typology of presbycusis and related conditions, the epidemiology of auditory impairment in old age, the design of testing and research, and the rehabilitation of the hearing-impaired elderly, are addressed. The NIA and the National Institute of Neurological and Communicative Disorders and Stroke (NINCDS) are coordinating their efforts to stimulate investigation of these and related topics.

Epidemic cluster of legionnaires disease in Paris, June 1998.

From 29 June to July 1998, four cases of legionnaires disease in British citizens were reported to the Reseau National de Sante Publique (RNSP) by the statutory notification system (declaration obligatoire (DO)) and by theEuropean Surveillance Scheme for

Estrogen use and postmenopausal women: a basis for informed decisions. NIH Consensus Development.

A panel of experts convened by the National Institute on Aging, National Institutes of Health, reached the following consensus regarding estrogen use and postmenopausal women. The use of estrogens alleviates vasomotor symptoms and atrophy of the vaginal epithelium and might aid in preventing osteoporosis. However, it increases the incidence of endometrial cancer. The addition of progestins might prevent this complication, but potential risks have not been adequately evaluated. Convincing evidence that postmenopausal estrogen use influences the occurrence of cardiovascular disease and breast cancer does not currently exist. Many aspects of the menopause and its management require further research. Any candidate for postmenopausal estrogen use should be given as much information as possible about both benefits and risks and then, with her physician, reach an individualized decision regarding whether to receive estrogens.

PIP: This National Institutes of Health consensus report of a panel of experts summarizes the currently available information on postmenopausal estrogen use, as presented by the invited speakers, panelists, and members of the audience, and each section published here represents an excerpt of the consensus statement followed by commentary. Reference to 3 background papers, which are published and available, is made for presentation of more detailed discussion. The following consensus was reached concerning estrogen use and postmenopausal women: 1) the use of estrogens alleviates vasomotor symptoms and atrophy of vaginal epithelium and may aid in preventing osteoporosis. The possibility of increased incidence of endometrial cancer with estrogen use is also acknowledged. Combinations of progestin and estrogen may alleviate this increased risk, but potential risks of progestin have not been studied adequately in postmenopausal women with no ovarian function. 2) there is no convincing evidence that postmenopausal estrogen use influences occurrence of cardiovascular disease and breast cancer. Also agreed upon is the patient management of a potential estrogen replacement therapy candidate: she should be given as much information as possible about both benefits and risks and with her physician's help, she should reach an individualized decision about estrogen use.

Medical journals in China.

About 500 medical journals are published in the People's Republic of China; circulations range from approximately 1000 to 130,000. Publishers include the Chinese Medical Association (which publishes the most heavily cited journals), the Chinese Academy of Medical Sciences, the Chinese Academy of Traditional Chinese Medicine, publishing houses, and academic institutions. In format, content, and operations, Chinese medical journals generally resemble their American counterparts, but they also differ. Their content consists largely of scientific papers (whose format is usually the same as that in the United States), case reports, and review articles. Case series are common, and reports of randomized clinical trials are rare. An estimated 20% of journals routinely include English-language abstracts, and the proportion is increasing. Papers are normally peer reviewed by at least two referees. Authors generally are paid on publication of a paper, and peer reviewers are also paid. The post office handles circulation for many journals.