By Kent Smitherman, MD, and Brian S. Alper, MD, MSPH

Dr. Smitherman is assistant professor of medicine, Department of Internal Medicine, Baylor College of Medicine, Ben Taub General Hospital, Houston, and a peer reviewer for DynaMed. Dr. Alper is medical director of clinical reference products for EBSCO Publishing, in Ipswich, Mass., and editor-in-chief of DynaMed (www.dynamicmedical.com), a database of comprehensive updated summaries covering nearly 2,000…