A defense of apple pie
Vaccination against pneumococcal pneumonia is widely accepted, although we underuse it, and data to support its efficacy are scarce.
B.F. MANDELL

Pneumococcal vaccination in adults:
Recommendations, trends, and prospects
Current vaccines against Streptococcus pneumoniae may not be ideal, but they are worth giving to elderly patients and others at risk.
P.V. TARGONSKI and G.A. POLAND

Radiologic diagnosis and management of acute lower gastrointestinal bleeding
When colonoscopy gives indeterminate results or cannot be performed, either radionuclide imaging or angiography is indicated.
S.A. PADIA, B. BYBEL, and J.S. NEWMAN

Heart failure in women is different than in men;
should treatment be different?
Studies of heart failure treatment have included mostly men, and the results have been generalized to women even though there are pharmacologic and pathophysiologic differences between the sexes.
U. MEZU, C. BOTT-SILVERMAN, and E. HSICH

Perhaps it is time for a change in policy on lung cancer screening
It is time to think seriously about using computed tomography as a screening test for lung cancer. We should include members of society beyond the scientific community in making this decision.
D.F. YANKELEVITZ

Lung cancer screening: Is it time for a change in policy?
Whether screening with computed tomography should be adopted remains open to debate, despite two large studies that were recently reported.
P. MAZZONE, N. OBUCHOWSKI, T. MEKHAIL, M. MEZIANE,
and M. AHMAD

A different approach to resistant hypertension
More patients with resistant hypertension could control their blood pressure if physicians would perform a physical examination to determine the hemodynamic mechanism driving the hypertension. More patients would receive diuretics and beta-blockers, and in higher doses.
S. HIRSCH

A 58-year-old woman with mental status changes
Thirty years ago she underwent gastric bypass surgery for obesity. Now she presents with mental status changes, a bicarbonate level of 16 mmol/L, and an anion gap of 15. What is the most likely cause of her acidosis?
M.R. BAKHRU, A. KUMAR, and A. ANEJA

Correction
Colon cancer screening (April 2007)