About This Journal FREE

To promote the art and science of medicine and the betterment of human health by publishing manuscripts of interest and relevance to internists practicing as generalists or as medical subspecialists.

Editor: James E. Dalen, MD, MPH 1840 E River Rd Suite 207 Tucson, AZ 85718

Deputy Editors: Farrell J. Lloyd, MD, MPH Scottsdale, Ariz Eskild A. Petersen, MD Tucson, Ariz Editorial Assistants: Moira F. Andre Tucson, Ariz Janet S. Frank Tucson, Ariz Lisa King Tucson, Ariz

Frederick R. Ahmann, MD Tucson, Ariz Joseph S. Alpert, MD Tucson, Ariz Christine K. Cassel, MD Portland, Ore William S. Dalton, MD Tampa, Fla M. Brian Fennerty, MD Portland, Ore Faith T. Fitzgerald, MD Sacramento, Calif Robert J. Goldberg, PhD Worcester, Mass John P. Howe III, MD Washington, DC Richard S. Liebowitz, MD Durham, NC Jack M. Matloff, MD Los Angeles, Calif

Offices: 515 N State St, Chicago, IL 60610 Catherine D. DeAngelis, MD, MPH Editor in Chief, Scientific Publications & Multimedia Applications

Cheryl Iverson Managing Editor

Department Director: Paula Glitman Copyediting Manager: Gwen Chaffen Freelance Copyediting Manager: Diane L. Cannon Freelance Copyediting Coordinators: Lauren B. Fischer, Connie Manno Editorial Systems Managers: Paul Frank, Monica Mungle Systems Programmer/Internet Specialist: J. D. Neff Senior Copy Editors: Dee E. Egger, Vickey Golden, John McFadden Copy Editors: Elisabeth Caron, Donald S. Smith Editorial Assistant: Wanda Hill

Assistant to the Editor: Helga Fritz

Director: Margaret Winker, MD Electronic Media Department Director: Michelle Kurzynski Associate Web Editors: Katherine Behar, Erin M. Giannini Web Office Manager: Marla A. Hall

Group Publisher: Nawin Gupta, PhD VP Office Staff: James Clinton, Geoffrey Flick, Terri Hanley, Maureen Archey, Anna Goins International Business and Development: William Fox (director), Norman Frankel, PhD, Rhonda Bailey, Millette Jackson-Bates Online Business and CME: Bonnie Chi-Lum, MD, MPH (publisher)

Director: Curt Reilly Managers: Vida Damijonaitis, Kim Krebs, Thalia Moss, Staff: Kathy Braun, Ana Dirksen, Sandra Garzon, Christine Hearne, Amy Postlewait, Trina Rizzo, Barbara Van Wagner

Director: Peter J. Murphy Sales Representatives: Peter G. Messina, Philip G. Soufleris Marketing Services: Nancy Bell, Staff: Victoria Anne Acot, Susan Lovenberg, Mirna Monal, Debra Ann Sardo

Director: Mark Kuhns, Staff: Wanda Bartolotta, Joseph Rekash

Division Director: Vanessa Hayden Directors: Karen Adams-Taylor, Paul Gasiecki, Sue Sherrill Managers: David Antos, Karen Branham, Debbie Camp, Diane Darnell, Karl Elvin, Betty Frigerio, Linda Gardner, Mary Ellen Johnston, Mark Matura, Michael McGraw, Phil O'Leary, Susan Price, Charl Richey, Alfred Tomaselli, Carmela Ware Advertising and Production Services: Linda Alexander, LaWanda Brown, Susan Chiara, Mary Anne Donley, Euwanaha Joiner-Smith, Brian McCartney, Sean O'Donnell, Noemi Olmo, Carole Piszker, Sarah Powell, Denise Steinhauser, Ellen Yoshihara Circulation Processing: Bernadette Bauer, Julie Burton, Rosa Eng, Felicia Kyles, Lawrence Majkszak, Kathryn Osten Composition and New Media: Rebecca Aiken, Clifford Barrett, Gail Barrett, Regina Brownlee, Brenda Chandler-Grayer, Rowena Dagang, Amy Evers, Mary Ann Kuranda, Sandra Lopez, John Marcinek, Bruce McGregor, La'son Diggs Sledge, Angela Smits Graphics: Joe Amft, Fred Furtner, Carolyn Hall, Maria Kowalkowski, Chris Meyer, JoAnne Weiskopf Proofreading: Carol Joy Farrell, Daniel James, Judith A. Literskis, Teresa H. Omiotek, Barbara Wojtowicz, Agnes A. Zarkadas

All articles published, including editorials, letters, and book reviews, represent the opinions of the authors and do not reflect the policy of the American Medical Association, the Editorial Board, or the institution with which the author is affiliated, unless this is clearly specified.

Copyright 2003 by the American Medical Association. All rights reserved. Reproduction without permission is prohibited.

Michael D. Maves, MD, MB Executive Vice President, Chief Executive Officer Robert A. Musacchio, PhD Senior Vice President, Publishing & Business Services