Developing a Peer Review Process for Web-based Curricula

The World Wide Web creates new challenges and opportunities for medical educators. Prominent among these are the lack of consistent standards by which to evaluate web-based educational tools. We present the instrument that was used to review web-based innovations in medical education submissions to the 2003 Society of General Internal Medicine (SGIM) national meeting, and discuss the process used by the SGIM web-based clinical curriculum interest group to develop the instrument. The 5 highest-ranked submissions are summarized with commentary from the reviewers.     

The aesthetics of hair restoration

The hairline and frontal hair volume are frequently overlooked aspects of attractive facial proportion and overall facial aesthetics. The author contends that patient benefit from hair restoration surgery is significant, and these procedures should be routinely considered as part of a complete facial rejuvenation.     

The J-curve relationship of treated diastolic blood pressure to mortality risk: Is it real? Is it clinically meaningful?

Low diastolic blood pressure is alleged to impose excess cardiovascular disease (CVD) risk in patients with treated hypertension, impeding aggressive reduction of blood pressure. Most investigations that assessed the potential J-shaped relations of diastolic blood pressure and adverse outcomes have not adequately considered systolic or pulse pressure in statistical analyses. An overview of hypertension trials indicates that lowering elevated blood pressure reduces the risk of CVD outcomes irrespective of the associated decrease in diastolic pressure, even if the achieved diastolic pressure averages less than 70 mm Hg. The Framingham study investigations have determined that the increased CVD incidence observed at low diastolic blood pressure levels is confined largely to persons with concomitantly increased systolic pressure. This finding of no true excess risk at low diastolic blood pressure agrees with the results of trials that have evaluated the J-curve phenomenon adjusting for systolic pressure. Aggressively treating systolic hypertension appears to produce no cause for alarm.