Access to medical information via the Internet has the potential to speed the transformation of the patient-physician relationship from that of physician authority ministering advice and treatment to that of shared decision making between patient and physician. However, barriers impeding this transformation include wide variations in quality of content on the Web, potential for commercial interests to influence online content, and uncertain preservation of personal privacy. To address these issues, the American Medical Association (AMA) has developed principles to guide development and posting of Web site content, govern acquisition and posting of online advertising and sponsorship, ensure site visitors' and patients' rights to privacy and confidentiality, and provide effective and secure means of e-commerce. While these guidelines were developed for the AMA Web sites and visitors to these sites, they also may be useful to other providers and users of medical information on the Web. These principles have been developed with the understanding that they will require frequent revision to keep pace with evolving technology and practices on the Internet. The AMA encourages review and feedback from readers, Web site visitors, policymakers, and all others interested in providing reliable quality information via the Web.

ABSTRACT:The effect of hypervolemic-hemodilution, with and without hypertension, on blood-brain barrier permeability was investigated in rats, after 180 minutes of middle cerebral artery occlusion (MCAo), and 60 minutes of reperfusion. One of the following conditions was maintained during MCAo: 1) Control — hematocrit and blood pressure were not manipulated; 2) Hypervolemic-Hemodilution/Normotension — the hematocrit was decreased to 30%; 3) Hypervolemic-Hemodilution/Hypertension — the hematocrit was decreased to 30% and mean arterial pressure increased by 30 mmHg with phenylphrine. In all groups, Evans Blue was administered, and its concentration determined by spectrophotometric assay. Evans Blue (μg{g-1 of brain tissue [mean ± SD]) was greater in the Hypervolemic- Hemodilution/Hypertension group (71 ± 20) versus the Control (13 ± 9) and Hypervolemic-Hemodilution/ Normotension (17 ± 10) groups (p < 0.05). No other differences were present. These results support the hypothesis that during MCAo, hypervolemic-hemodilution/hypertensive therapy effects an increase in blood-brain barrier permeability in the early period of reperfusion.

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MEDICAL STUDENTS and primary care residents may not be receiving enough training in preventing disease.Two sessions at the 12th annual preventive medicine meeting, Prevention 95, held in New Orleans, La, focused on the teaching of preventive medicine in medical school and primary care residencies.Although no one discounts the importance of prevention, instructors of medical students and primary care residents report experiencing difficulty in finding adequate time to teach the fundamentals of preventive medicine along with the rest of the required curriculum.According to conference speaker S.

The CoverAlthough usually thought of as essentially a realistic painter, British artist David Hockney (1937-) has also ex¬ plored such diverse techniques as photography, printmaking, lithographs, etchings, photographic collages, and even draw¬ ings transmitted through facsimile machines. He has also achieved international acclaim as a stage-set designer for the opera and ballet. He recently designed the costumes and scenery for 12 opera arias for the television broadcast of Placido Domingo's "Operalia 1994" in Mexico City.Hockney was born into a working-class family of five chil¬ dren from Bradford in Yorkshire, England. His father, an amateur painter, encouraged the boy's interest in art and lit¬ erature from an early age. By age 11, young Hockney had decided to become an artist, and he enrolled in the local Bradford School of Art in 1953 after completing his second¬ ary education. At the Bradford School of Art he received

The 16th edition of Contempo continues THE JOURNAL'S tra¬ dition of updating physicians on major advances and devel¬ opments in fields other than their own. Each year THE JOUR¬ NAL has furthered this objective by inviting editorial board members and experts in selected specialties to contribute to the issue. This year's issue continues our traditional objective but with an added goal. Contempo 1995 strives not only to inform physicians about the latest developments in medicine,