Table of Contents

January 5, 1999; 130 (1)

Articles

  • Probable Transmission of HIV from an Orthopedic Surgeon to a Patient in France

    • Florence Lot,
    • Jean-Christophe Séguier,
    • Sophie Fégueux,
    • Pascal Astagneau,
    • Philippe Simon,
    • Michèle Aggoune,
    • Patrice van Amerongen,
    • Martine Ruch,
    • Mireille Cheron,
    • Gilles Brücker,
    • Jean-Claude Desenclos,
    • and Jacques Drucker
    Ann Intern Med January 5, 1999 130:1-6

    In October 1995, the French Ministry of Health offered HIV testing to patients who had been operated on by an orthopedic surgeon in whom AIDS was recently diagnosed. The one HIV-positive patient identified was HIV-negative before surgery and had viral sequences closely related to those obtained from the surgeon. This finding suggests that the surgeon may have transmitted HIV to this patient during surgery.

  • Chelation Therapy for Patients with Elevated Body Lead Burden and Progressive Renal Insufficiency: A Randomized, Controlled Trial

    • Ja-Liang Lin,
    • Huei-Huang Ho,
    • and Chun-Chen Yu
    Ann Intern Med January 5, 1999 130:7-13

    Chelation therapy appears to slow the progression of renal insufficiency in patients with mildly elevated body lead burden. This implies that long-term exposure to low levels of environmental lead may be associated with impaired renal function in patients with chronic renal disease.

  • Frequency of Major Complications of Aspirin, Warfarin, and Intravenous Heparin for Secondary Stroke Prevention: A Population-Based Study

    • George W. Petty,
    • Robert D. Brown, Jr.,
    • Jack P. Whisnant,
    • JoRean D. Sicks,
    • W. Michael O'Fallon,
    • and David O. Wiebers
    Ann Intern Med January 5, 1999 130:14-22

    In this study, complication rates for warfarin and intravenous heparin given for secondary stroke prevention were lower than rates reported from earlier trials and observational studies. For warfarin, however, these rates were higher than those found in more recent randomized trials. Rates were higher for heparin than for aspirin and warfarin. These rates can be used to judge the applicability of complication rates derived from ongoing clinical trials.

  • Physiologic Left Ventricular Cavity Dilatation in Elite Athletes

    • Antonio Pelliccia,
    • Franco Culasso,
    • Fernando M. Di Paolo,
    • and Barry J. Maron
    Ann Intern Med January 5, 1999 130:23-31

    In a sample of highly trained athletes, left ventricular cavity dimension varied widely but was strikingly increased to a degree compatible with primary dilated cardiomyopathy in almost 15% of patients. When systolic dysfunction is absent, this dilatation is probably an extreme physiologic adaptation to intensive athletic conditioning.

Brief Communications

  • Comparison of Culture-Confirmed Erythema Migrans Caused by Borrelia burgdorferi sensu stricto in New York State and by Borrelia afzelii in Slovenia

    • Franc Strle,
    • Robert B. Nadelman,
    • Joze Cimperman,
    • John Nowakowski,
    • Roger N. Picken,
    • Ira Schwartz,
    • Vera Maraspin,
    • Maria E. Aguero-Rosenfeld,
    • Shobha Varde,
    • Stanka Lotric-Furlan,
    • and Gary P. Wormser
    Ann Intern Med January 5, 1999 130:32-36

    Erythema migrans caused by Borrelia afzelii in Slovenia and erythema migrans caused by B. burgdorferi in New York have distinct clinical presentations. Caution should be used when clinical and laboratory experience from one side of the Atlantic is applied to patients on the other side.

  • Misdiagnosis of HIV Infection by HIV-1 Plasma Viral Load Testing: A Case Series

    • Josiah D. Rich,
    • Nathan A. Merriman,
    • Eleftherios Mylonakis,
    • Thomas C. Greenough,
    • Timothy P. Flanigan,
    • Brian J. Mady,
    • and Charles C.J. Carpenter
    Ann Intern Med January 5, 1999 130:37-39

    The availability of sensitive assays for plasma HIV viral load and the trend toward earlier and more aggressive treatment of HIV infection have led to the inappropriate use of these assays as primary tools for the diagnosis of acute HIV infection. Physicians should be cautious when using these assays to detect primary HIV infection, especially when the pretest probability of infection is low.

  • Effect of Inhaled Nitric Oxide on Gas Exchange in Patients with Congestive Heart Failure: A Randomized, Controlled Trial

    • Akihiro Matsumoto,
    • Shin-ichi Momomura,
    • Seiryo Sugiura,
    • Hideo Fujita,
    • Teruhiko Aoyagi,
    • Masataka Sata,
    • Masao Omata,
    • and Yasunobu Hirata
    Ann Intern Med January 5, 1999 130:40-44

    In this study, nitric oxide inhalation improved gas exchange in patients with congestive heart failure. This treatment may be useful as supportive therapy when other conventional vasodilators worsen gas exchange.

Academia and Clinic

  • Occupational Exposures to Body Fluids among Medical Students: A Seven-Year Longitudinal Study

    • Emilie H.S. Osborn,
    • Maxine A. Papadakis,
    • and Julie Louise Gerberding
    Ann Intern Med January 5, 1999 130:45-51

    Medical students may be at high risk for occupational exposures to blood. This study found that instruction in universal precautions is not sufficient to prevent exposures to blood during medical training. Medical schools must assume greater responsibility for ensuring that students are proficient in the safe conduct of clinical procedures and must develop systems so that students can report and learn from their mistakes.

Updates

  • Update in Hepatology

    • Eugene R. Schiff
    Ann Intern Med January 5, 1999 130:52-57

    Among the many topics related to hepatology that gained attention in 1997, this Update focuses on viral hepatitis, other types of liver disease, complications of cirrhosis, and liver transplantation.

History of Medicine

  • The Wenckebach Phenomenon: A Salute and Comment on the Centennial of Its Original Description

    • Charles B. Upshaw, Jr. and
    • Mark E. Silverman
    Ann Intern Med January 5, 1999 130:58-63

    In 1899, Karel F. Wenckebach unraveled the complicated arrhythmia that bears his name. He is remembered for his insight into atrioventricular circulation, which is as valid today as it was a century ago.

Editorials

  • Provider-to-Patient HIV Transmission: How To Keep It Exceedingly Rare

    • Julie Gerberding
    Ann Intern Med January 5, 1999 130:64-65

    In this issue, Lot and colleagues report what they believe to be the first case of HIV transmission from an infected surgeon to a patient during a surgical procedure. It is reassuring that this is only the second reported instance of an infected health care provider transmitting HIV to a patient. Rational prevention policies will further reduce this very small risk.

  • Protecting the Future of Medicine—from Themselves

    • Daniel D. Federman
    Ann Intern Med January 5, 1999 130:66-67

    Medical students participate actively in patient care and thus incur some of the risks of experienced physicians, especially the risk for exposure to bloodborne viruses. As a result, schools must train their students in safe procedures and establish response capacities for any break in technique that leads to a possible exposure to bloodborne pathogens. In this issue, Osborn and colleagues describe an outstanding approach to this problem.

  • Adenocarcinoma of the Esophagus and Gastric Cardia: Is There Progress in the Face of Increasing Cancer Incidence?

    • Richard E. Sampliner
    Ann Intern Med January 5, 1999 130:67-69

    Our understanding of the molecular biology of adenocarcinoma of the esophagus and gastric cardia and of Barrett esophagus is increasing. However, the cause of the increasing incidence of adenocarcinoma is not yet known, and this limits our ability to intervene to reduce the incidence.

On Being a Doctor

  • Curiosity

    • Faith T. Fitzgerald
    Ann Intern Med January 5, 1999 130:70-72

    What is the relation between “humaneness” and curiosity? How is curiosity suppressed in medical students and physicians?

On Being a Patient

  • Lester's Getting a Bottle

    • Keith Luther
    Ann Intern Med January 5, 1999 130:73-74

    After hospitalization for pancreatitis, Henry returns to the hotel where he lives and faces the challenge not to drink.

Letters

  • Appropriateness of Spinal Manipulation

    • Peter G. Hill
    Ann Intern Med January 5, 1999 130:75

  • Appropriateness of Spinal Manipulation

    • Myron M. LaBan and
    • Ronald S. Taylor
    Ann Intern Med January 5, 1999 130:75

  • Appropriateness of Spinal Manipulation

    • Louis Sportelli
    Ann Intern Med January 5, 1999 130:75-76

  • Appropriateness of Spinal Manipulation

    • Paul G. Shekelle,
    • Ian A. Coulter,
    • and Robert H. Brook
    Ann Intern Med January 5, 1999 130:76

  • The Medical Consultant's Role in Caring for Patients with Hip Fracture

    • Kiran G. Zaveri
    Ann Intern Med January 5, 1999 130:76

  • The Medical Consultant's Role in Caring for Patients with Hip Fracture

    • R. Sean Morrison,
    • Mark R. Chassin,
    • MPP,
    • and Albert L. Siu
    Ann Intern Med January 5, 1999 130:76-77

  • Low-Molecular-Weight Heparin for Treating Venous Thromboembolism

    • Michael Scott Mahoney and
    • Marc Kahn
    Ann Intern Med January 5, 1999 130:77

  • Low-Molecular-Weight Heparin for Treating Venous Thromboembolism

    • Maria M.W. Koopman and
    • Harry R. Büller
    Ann Intern Med January 5, 1999 130:77-78

  • Static Electricity Stops a Recalcitrant Arrhythmia

    • Thomas Screnock
    Ann Intern Med January 5, 1999 130:78

  • Ocular Venous Occlusion and Hyperhomocysteinemia

    • Emile L.E. de Bruijne,
    • Gonneke H.J.C. Keulen-de Vos,
    • and Rob J.Th. Ouwendijk
    Ann Intern Med January 5, 1999 130:78

  • Giant-Cell Arteritis Presenting as Mondor Disease

    • Emmanuel J. Diamantopoulos,
    • Georgia Yfanti,
    • and Emmanual Andreadis
    Ann Intern Med January 5, 1999 130:78-79

  • AIDS Exceptionalism

    • Robert K. Bolan
    Ann Intern Med January 5, 1999 130:79

  • AIDS Exceptionalism

    • Mary Bessesen,
    • Marianne McCollum,
    • and BCBS
    Ann Intern Med January 5, 1999 130:79-80

  • AIDS Exceptionalism

    • Richard Frothingham
    Ann Intern Med January 5, 1999 130:80

  • AIDS Exceptionalism

    • David Casarett and
    • John Lantos
    Ann Intern Med January 5, 1999 130:80

  • Characteristics of Primary HIV Infection

    • Abigail A. Silvers
    Ann Intern Med January 5, 1999 130:80

  • Characteristics of Primary HIV Infection

    • Lawrence Corey and
    • Timothy Schacker
    Ann Intern Med January 5, 1999 130:80-81

  • The Death of House Officers

    • Chi-yuan Hsu
    Ann Intern Med January 5, 1999 130:81

  • The Death of House Officers

    • Andrew Naidech
    Ann Intern Med January 5, 1999 130:81

  • The Death of House Officers

    • Faith T. Fitzgerald
    Ann Intern Med January 5, 1999 130:81

Medical Writings

  • End-of-Life Care in Medical Textbooks

    • Annette T. Carron,
    • Joanne Lynn,
    • and Patrick Keaney
    Ann Intern Med January 5, 1999 130:82-86

    Improvement in end-of-life care has become a demand of the public and a priority for health care professionals. Medical textbooks could support this improvement by functioning as educational resources and reference material. This paper evaluates four widely used general internal medicine textbooks for their coverage of the clinical management of patients in advanced stages of fatal illnesses.

Medical Writings: Book Notes

  • The Washington Manual of Medical Therapeutics

    • Ruric Anderson
    Ann Intern Med January 5, 1999 130:87

  • Partnerships in Healthcare: Transforming Relational Processes

    • Robert M. Arnold
    Ann Intern Med January 5, 1999 130:87-88

  • Sudden Cardiac Death in the Athlete

    • Monty M. Bodenheimer
    Ann Intern Med January 5, 1999 130:88

  • Handbook of Psychosomatic Medicine

    • Karen B. Kreiner
    Ann Intern Med January 5, 1999 130:88

Book Listings

Medical Notices

  • Medical Notices

    Ann Intern Med January 5, 1999 130:0
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This Issue

January 5, 1999; 130 (1)
  1. Articles
  2. Brief Communications
  3. Academia and Clinic
  4. Updates
  5. History of Medicine
  6. Editorials
  7. On Being a Doctor
  8. On Being a Patient
  9. Letters
  10. Medical Writings
  11. Medical Writings: Book Notes
  12. Book Listings
  13. Medical Notices

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