Your Body: Lungs

"Your Body: 2003" [Jan. 7] provided a useful summary of recent research on key body systems, but I am writing to clarify an important part of the lungs section.

Under "Recommendations," you report that the American Academy of Allergy, Asthma and Immunology (AAAAI) has new asthma management guidelines posted on its Web site. The entire asthma guidelines are not new; five selected topics of the asthma guidelines have been updated. Furthermore, the original source of the update is omitted, and a convoluted route to access the update is provided.

You would better serve your readers by accurately citing the source of the update and providing a more direct path to the information. The Guidelines for the Diagnosis and Management of Asthma -- Update on Selected Topics 2002 was released in June 2002 by the National Asthma Education and Prevention Program (NAEPP). The guidelines update can be found at www.nhlbi.nih.gov/guidelines/asthma/index.htm. Or, from the NHLBI home page (www.nhlbi.nih.gov), click on "Clinical Guidelines" (listed on left of screen); under "Asthma," click on "Update on Selected Topics 2002."

Other information produced by the NAEPP for consumers include "Facts About Controlling Your Asthma" (available in English and Spanish) and "Students with Chronic Illnesses: Guidance for Families, Schools and Students." For health professionals, NAEPP produces slide sets and guidelines tools for use with Palm OS devices, as well as print and Web-based publications. For more information, click on "Health Information" at www.nhlbi.nih.gov.

Diana Schmidt

Coordinator

National Asthma Education

And Prevention Program

Bethesda

Your Body: Privates

While scanning through the reproductive system in "Your Body: 2003," I took notice that a key part was not represented: the ovaries.

I realize that the purpose of the article was to highlight advances in each area, and unfortunately there haven't been any for ovarian cancer recently. This fact underscores the importance of building awareness and educating all women. Ovarian cancer is the deadliest of all gynecologic cancers, and there are no screening tests for the general public. Based on these two facts alone, ovarian cancer certainly deserves mention.

At the moment, awareness and education are the only tools we have to try to ensure that ovarian cancer is brought to the attention of the public.

To learn more about ovarian cancer and the Ovarian Cancer National Alliance, please visit our Web site at www.ovariancancer.org.

Patricia A. Goldman

President

Ovarian Cancer National Alliance

Washington

Your Body: Bones

On behalf of the National Osteoporosis Foundation (NOF), we applaud the excellent information on osteoporosis that was included in "Your Body: 2003." Osteoporosis and low bone mass are a public health threat for an estimated 44 million Americans aged 50 and older. It is also important to note that osteoporosis is a concern across the lifespan, and there are steps that can be taken at each lifestage related to prevention and treatment.

Also, as there is often confusion about osteoporosis and osteoarthritis, it is important to underscore the differences. Osteoporosis is a disease that results in thinning bones that can lead to fracture. Osteoarthritis, a degenerative joint disease that leads to the thinning or destruction of the cartilage, is an entirely separate condition. In addition, the correct estimated national direct expenditures for osteoporosis and associated fractures were $17 billion in 2001, or $47 million each day.

Judith A. Cranford

Executive Director

National Osteoporosis Foundation

Washington

Seeking Treatments for Alzheimer's

"An Uncertain Inheritance" [Dec. 17] highlighted the benefits of participating in clinical research examining family members of patients with Alzheimer's disease, and also mentioned clinical trials of new therapies for people with the disease.

We wish to point out that there are opportunities in our area, at Georgetown University and at the National Institutes of Health, to participate in tests of new treatments for Alzheimer's.

There has been huge progress in research into the causes of the disease, and the result is a number of promising treatments. The faster clinical studies can be completed, the faster new treatments become available to all who can benefit.

Carolyn Ward

Program Coordinator

Memory Disorders Program

Georgetown University Medical Center

Washington

When Doctors Play Monopoly

"Happy Birthday, Elaina Link "[The System, Dec. 24] highlights a problem that occurs frequently: physicians with hospital-based practices that refuse to accept contracts between HMOs and PPOs and the hospitals. As a former employee benefits manager for a Fortune 100 company, I saw this complaint frequently. Your column centered its inquiry on the insurer. It failed, however, to question the physicians and their refusal to contract. While they may feel that the reimbursement rates are too low, those doctors hold a monopoly in the hospitals in which they practice. Patients do not have a real choice of anesthesiologist, radiologist or many other specialists. This lack of choice is not just because patients are groggy, in pain, etc. It would be there even if the patient was lucid, facing a procedure to be done days or weeks in the future.

Alan Peres

Oak Park, Ill.