Table of Contents

January 19, 1999; 130 (2)

Articles

  • The Association between Cardiorespiratory Fitness and Impaired Fasting Glucose and Type 2 Diabetes Mellitus in Men

    • Ming Wei,
    • Larry W. Gibbons,
    • Tedd L. Mitchell,
    • James B. Kampert,
    • Chong D. Lee,
    • and Steven N. Blair
    Ann Intern Med January 19, 1999 130:89-96

    Low cardiorespiratory fitness was associated with increased risk for impaired fasting glucose and type 2 diabetes. A sedentary lifestyle may contribute to the progression from normal fasting glucose to impaired fasting glucose and diabetes.

  • The Costs, Clinical Benefits, and Cost-Effectiveness of Screening for Cervical Cancer in HIV-Infected Women

    • Sue J. Goldie,
    • Milton C. Weinstein,
    • Karen M. Kuntz,
    • and Kenneth A. Freedberg
    Ann Intern Med January 19, 1999 130:97-107

    Women with HIV infection have a higher risk for cervical squamous intraepithelial lesions than do women without HIV infection. In HIV-infected women, cervical cancer screening with annual Papanicolaou smears after two negative smears obtained 6 months apart offers quality-adjusted life expectancy benefits at a cost comparable to that of other clinical preventive measures.

  • Medical Therapy after Successful Percutaneous Coronary Revascularization

    • David Hasdai,
    • Amir Lerman,
    • Diane E. Grill,
    • Charanjit S. Rihal,
    • and David R. Holmes, Jr.
    Ann Intern Med January 19, 1999 130:108-115

    In this study, successful percutaneous coronary revascularization did not substantially supplant the use of antianginal medications, which were commonly used despite the marked improvement in anginal status. This finding may reflect reluctance to alter therapy once symptoms of angina subside.

  • Patient Age and Decisions To Withhold Life-Sustaining Treatments from Seriously Ill, Hospitalized Adults

    • Mary Beth Hamel,
    • Joan M. Teno,
    • Lee Goldman,
    • Joanne Lynn,
    • Roger B. Davis,
    • Anthony N. Galanos,
    • Norman Desbiens,
    • Alfred F. Connors, Jr.,
    • Neil Wenger,
    • Russell S. Phillips,
    • and for the SUPPORT Investigators
    Ann Intern Med January 19, 1999 130:116-125

    Patient age may influence decisions to withhold life-sustaining treatments, independent of patients' preferences for and ability to benefit from such treatments. This study found that even after adjustment for differences in patients' prognoses and preferences, older age was associated with higher rates of decisions to withhold ventilator support, surgery, and dialysis.

Brief Communications

  • Compliance with Handwashing in a Teaching Hospital

    • Didier Pittet,
    • Philippe Mourouga,
    • Thomas V. Perneger,
    • and and the Members of the Infection Control Program
    Ann Intern Med January 19, 1999 130:126-130

    Transmission of microorganisms from the hands of health care workers is the main source of cross-infection in hospitals and can be prevented by handwashing. In this study, compliance with handwashing was moderate. The variation across hospital ward and type of health care worker suggests that targeted educational programs may help improve compliance with handwashing guidelines.

  • Epidemiologic and Molecular Investigation of Outbreaks of Hepatitis C Virus Infection on a Pediatric Oncology Service

    • Anders Widell,
    • Bertil Christensson,
    • Thomas Wiebe,
    • Claes Schalén,
    • Hans Bertil Hansson,
    • Tobias Allander,
    • and Mats A.A. Persson
    Ann Intern Med January 19, 1999 130:130-134

    In a pediatric oncology ward, a patient infected with HCV genotype 1b generated nine subsequent cases of infection. Contamination of multidose vials was the most likely mode of HCV transmission.

Perspectives

  • The Trouble with Families: Toward an Ethic of Accommodation

    • Carol Levine and
    • Connie Zuckerman
    Ann Intern Med January 19, 1999 130:148-152

    A persistent tendency to equate patients' families with trouble is evident in both the literature and the practice of medicine. Physicians' primary responsibilities are to their patients, but physicians should try to adhere to an ethic of accommodation. This ethic emphasizes the need to negotiate care plans that do not compromise patients' basic interests but do recognize the importance, capacities, and limitations of family members.

Medicine and Public Issues

  • A Shared Statement of Ethical Principles for Those Who Shape and Give Health Care: A Working Draft from the Tavistock Group

    • Richard Smith,
    • Howard Hiatt,
    • and Donald Berwick
    Ann Intern Med January 19, 1999 130:143-147

    Many groups of professionals that give and affect health care have established separate codes of ethics for their own disciplines, but no shared code exists that might bring all stakeholders in health care into a more consistent moral framework. Responding to this concern, a multidisciplinary group recently developed a basic and generic statement of ethical principles. The statement is intended to offer clear guidance for tough calls in real-world settings.

Editorials

  • It Is Time for Action: Improving Hand Hygiene in Hospitals

    • John M. Boyce
    Ann Intern Med January 19, 1999 130:153-155

    As indicated in Pittet and colleagues' study in this issue, careful handwashing or antisepsis remains one of the most important measures for preventing the spread of pathogens in the hospital. After tolerating poor handwashing compliance for 150 years, it is time for hospitals and health care professionals to get serious about improving hand hygiene in hospitals.

  • A Novel Antimicrobial Agent Joins the Battle against Resistant Bacteria

    • Robert C. Moellering, Jr.
    Ann Intern Med January 19, 1999 130:155-157

    A disturbing number of reports have shown the inexorable development of bacterial resistance to almost all available antimicrobial agents. Development of the drug linezolid suggests that we may not have exhausted the opportunities to find antimicrobial agents with novel mechanisms of action. However, we cannot continue to rely on the discovery of antimicrobial agents as the principal element in the control of bacterial disease.

On Being a Doctor

  • A Simple Procedure: A Play in One Act

    • Robert Burns
    Ann Intern Med January 19, 1999 130:158-160

    A physician and his new patient try to talk to each other.

Letters

  • Screening for Thyroid Disease

    • Glen L. Hortin
    Ann Intern Med January 19, 1999 130:161

  • Screening for Thyroid Disease

    • Flavio Zelmanovitz
    Ann Intern Med January 19, 1999 130:161

  • Screening for Thyroid Disease

    • Mark N. Friedman
    Ann Intern Med January 19, 1999 130:161-162

  • Screening for Thyroid Disease

    • Robert S. Dieter
    Ann Intern Med January 19, 1999 130:162

  • Screening for Thyroid Disease

    • Mark Helfand and
    • Craig C. Redfern
    Ann Intern Med January 19, 1999 130:162

  • Impaired Glucose Tolerance in HIV-Positive Patients Receiving and Those Not Receiving Protease Inhibitors

    • Stefan Mauss,
    • Eva Wolf,
    • and Hans Jaeger
    Ann Intern Med January 19, 1999 130:162-163

  • Thrombotic Thrombocytopenic Purpura after Ecstasy-Induced Acute Liver Failure

    • Carl Albrecht Schirren,
    • Thomas M. Berghaus,
    • and Michael Sackmann
    Ann Intern Med January 19, 1999 130:163

  • Severe Hepatotoxicity Associated with Troglitazone

    • Steven K. Herrine and
    • Cuckoo Choudhary
    Ann Intern Med January 19, 1999 130:163-164

  • Current Health Care Environment

    • Edward J. Volpintesta
    Ann Intern Med January 19, 1999 130:164

  • Current Health Care Environment

    • Gene H. Ginsberg
    Ann Intern Med January 19, 1999 130:164

  • Current Health Care Environment

    • Albert DiPiero
    Ann Intern Med January 19, 1999 130:164-165

  • Current Health Care Environment

    • James P. Nolan
    Ann Intern Med January 19, 1999 130:165

  • Doing Everything

    • Nancy S. Knudsen
    Ann Intern Med January 19, 1999 130:165

  • Doing Everything

    • David S. Pisetsky
    Ann Intern Med January 19, 1999 130:165-166

  • Preservation of the Chief Medical Residency

    • Robert S. Crausman and
    • Yul D. Ejnes
    Ann Intern Med January 19, 1999 130:166

Medical Writings

  • Racing to the Beginning of the Road: The Search for the Origin of Cancer

    • William R. Jewell
    Ann Intern Med January 19, 1999 130:167

  • Case Studies from Primary Care Settings

    • Philippe O. Szapary
    Ann Intern Med January 19, 1999 130:167-168

  • Handbook of Differential Diagnosis in Internal Medicine: Medical Book of Lists

    • Mohan Singh Dhariwal
    Ann Intern Med January 19, 1999 130:168

  • Genetics Manual: Current Theory, Concepts, Terms

    • Michael R. Cummings
    Ann Intern Med January 19, 1999 130:168

Currents

  • Solid Organ Transplantation. 2: Ethical Considerations

    • Paul Kefalides
    Ann Intern Med January 19, 1999 130:169-170

  • Ideas and Trends: Medical Informatics and Health Care Computing

    • Chris Dwyer
    Ann Intern Med January 19, 1999 130:170-172

Book Listings

Medical Notices

  • Medical Notices

    Ann Intern Med January 19, 1999 130:0

Updates from the Annual Session

  • Update in Rheumatology

    • Stephen M. Campbell and
    • Richard Wernick
    Ann Intern Med January 19, 1999 130:135-142

    The 1997 literature included important information on new treatment approaches to rheumatoid arthritis, ways to moderate toxic effects of antirheumatic drugs, state-of-the-art laboratory testing, and low back pain.

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This Issue

January 19, 1999; 130 (2)
  1. Articles
  2. Brief Communications
  3. Perspectives
  4. Medicine and Public Issues
  5. Editorials
  6. On Being a Doctor
  7. Letters
  8. Medical Writings
  9. Currents
  10. Book Listings
  11. Medical Notices
  12. Updates from the Annual Session

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