This article provides long-term mortality results of a randomized trial of a smoking cessation program. Only 21.7% in the intervention group had stopped smoking at 5 years (compared with 5.4% of controls). Nonetheless, all-cause mortality per 1000 person-years was 8.83 deaths in the intervention group and 10.38 deaths in the control group. Smoking cessation programs substantially reduce mortality even when only a minority of patients stop smoking.

In patients with hepatitis B e antigen–positive chronic hepatitis B, combination treatment with pegylated interferon-α2b and lamivudine may lead to a higher rate of virologic response than lamivudine monotherapy. The rate of sustained virologic response was 36% for combination therapy and 14% for lamivudine monotherapy.

In patients with high-risk acute coronary syndromes, 1 year of therapy with clopidogrel plus aspirin followed by life-long aspirin results in greater life expectancy than life-long aspirin alone. The cost-effectiveness of adding clopidogrel—$15 400 per quality-adjusted life-year—is similar to that of many well-accepted interventions.

The authors systematically reviewed studies relating medical knowledge and health care quality to years in practice and physician age. Seventy-three percent of the evaluations showed decreasing performance with increasing years in practice for all or some of the outcomes assessed. Four percent of evaluations showed improving performance with increasing experience. Physicians who have been in practice longer may be at risk for providing lower-quality care.

This review discusses current concepts in the clinical presentation and diagnosis of celiac disease. It describes the pathogenesis of the disease; the diagnostic usefulness of serologic markers, including the sensitivity and specificity of available tests; and the association of celiac disease with other disorders.

This year's Update in Pulmonary Diseases incorporates articles on mechanical ventilation, obstructive lung disease, and pulmonary infection.

This article provides recommendations on how to write a grant for clinical research. It describes specific problems that grant reviewers frequently identify in their critiques and shows how to avoid these problems.

The new results from the Lung Health Study, reported in this issue, confirm again that smoking cessation prolongs life. In addition to their public health importance, these findings remind clinicians that interventions do increase the rate of successful quitting. The implications are obvious: Physicians should obtain a smoking history from all patients, and they should help smokers quit.

The medical profession cannot ignore the striking findings reported by Choudhry and colleagues and their implications: Practice does not make perfect. Physicians must make an ongoing vigorous effort to maintain their knowledge and skills, and they must work actively to sustain the quality of care in their practice.

Dean, 87, and his wife Donna, 78, would ritualistically arrive every 3 months in my geriatrics clinic, rain or shine. They had been married for 61 years. From the beginning, Donna ably presumed the spokesperson's role and impressed me as a reliable and caring informant who knew Dean more than he knew himself.