Table of Contents

May 4, 1999; 130 (9)

Articles

  • Cost-Effectiveness of Diagnostic Strategies for Patients with Chest Pain

    • Karen M. Kuntz,
    • Kirsten E. Fleischmann,
    • Maria G.M. Hunink,
    • and Pamela S. Douglas
    Ann Intern Med May 4, 1999 130:709-718

    Exercise electrocardiography or exercise echocardiography resulted in reasonable diagnostic cost-effectiveness ratios for patients at mild to moderate risk for coronary artery disease in terms of age, sex, and type of chest pain. Coronary angiography without previous noninvasive testing resulted in reasonable cost-effectiveness ratios for patients with a high pretest probability of coronary artery disease.

  • Cost-Effectiveness of Alternative Test Strategies for the Diagnosis of Coronary Artery Disease

    • Alan M. Garber and
    • Neil A. Solomon
    Ann Intern Med May 4, 1999 130:719-728

    Echocardiography, single-photon emission computed tomography, and immediate angiography are cost-effective diagnostic alternatives to positron emission tomography and other diagnostic approaches. Test selection should reflect local variation in test accuracy.

  • Use of Tunneled Femoral Catheters To Prevent Catheter-Related Infection: A Randomized, Controlled Trial

    • Jean-François Timsit,
    • Fabrice Bruneel,
    • Christine Cheval,
    • Marie-France Mamzer,
    • Maïté Garrouste-Orgeas,
    • Michel Wolff,
    • Benoît Misset,
    • Sylvie Chevret,
    • Bernard Regnier,
    • and Jean Carlet
    Ann Intern Med May 4, 1999 130:729-735

    The incidence of femoral catheter–related infections in critically ill patients can be reduced by using catheters that are subcutaneously tunneled.

Brief Communications

  • Increased Risk for Fetal Loss in Carriers of the Factor V Leiden Mutation

    • Johan R. Meinardi,
    • Saskia Middeldorp,
    • Pieter J. de Kam,
    • Maria M.W. Koopman,
    • Elisabeth C.M. van Pampus,
    • Karly Hamulyák,
    • Martin H. Prins,
    • Harry R. Büller,
    • and Jan van der Meer
    Ann Intern Med May 4, 1999 130:736-739

    Carriers of the factor V Leiden mutation have a greater risk for fetal loss than noncarriers. These data further suggest a greater risk for recurrence of fetal loss in carriers than in noncarriers and a greater risk for fetal loss and stillbirth in homozygous carriers than in heterozygous carriers.

  • Compassionate Use of Continuous Prostacyclin in the Management of Secondary Pulmonary Hypertension: A Case Series

    • Vallerie V. McLaughlin,
    • Diane E. Genthner,
    • Maureen M. Panella,
    • Dina M. Hess,
    • and Stuart Rich
    Ann Intern Med May 4, 1999 130:740-743

    Intravenous prostacyclin may be effective in the treatment of certain types of secondary pulmonary hypertension.

Academia and Clinic

  • Discussing Palliative Care with Patients

    • Bernard Lo,
    • Timothy Quill,
    • James Tulsky,
    • and for the ACP-ASIM End-of-Life Care Consensus Panel
    Ann Intern Med May 4, 1999 130:744-749

    In addition to addressing the physical suffering of dying patients, physicians can extend their caring by acknowledging and exploring psychosocial, existential, or spiritual suffering. As patients struggle to find closure in their lives, active listening and empathy have therapeutic value in and of themselves.

Review

  • The Effect of Thyroid Hormone on Skeletal Integrity

    • Susan L. Greenspan and
    • Francis S. Greenspan
    Ann Intern Med May 4, 1999 130:750-758

    Women with a history of hyperthyroidism or thyroid-stimulating hormone suppression by thyroid hormone should have skeletal status assessed by bone mineral densitometry, preferably at a site containing cortical bone.

NIH Conferences

  • Adrenocortical Tumors: Recent Advances in Basic Concepts and Clinical Management

    • Stefan R. Bornstein,
    • Constantine A. Stratakis,
    • and George P. Chrousos
    Ann Intern Med May 4, 1999 130:759-771

    Adrenocortical masses are among the most common tumors in humans. This paper discusses new aspects of adrenocortical tumorigenesis, the implications of these aspects, and the recent advances in the diagnosis and management of adrenocortical tumors.

Editorials

  • Care at the End of Life: Guiding Practice Where There Are No Easy Answers

    • Bernard Lo,
    • Lois Snyder,
    • and Harold C. Sox
    Ann Intern Med May 4, 1999 130:772-774

    The paper by Lo and colleagues in this issue launches a new series of articles about end-of-life care. These articles will provide practical advice and guidance to clinicians who are not specialists in palliative care and for whom the care of dying patients is not an everyday aspect of their practice.

  • The Making and Unmaking of a Journal

    • Frank Davidoff
    Ann Intern Med May 4, 1999 130:774-775

    Much has been made of the recent firing of the editor of the Journal of the American Medical Association. What's gotten lost in all the shouting about personalities and principles, unfortunately, is the pragmatic issue of how hard it is to build a journal and how easy it is to destroy one.

On Being a Doctor

  • Saving Lives and Saving Deaths

    • Judith E. Nelson
    Ann Intern Med May 4, 1999 130:776-777

    When it is not possible to save a life, I have learned and have begun to teach how to save a death—to help a patient preserve comfort and dignity despite overwhelming illness and to help a family understand the inevitability of the death.

Letters

  • Screening Tests for Alcohol Use Disorders

    • Warren G. Thompson
    Ann Intern Med May 4, 1999 130:779

  • Screening Tests for Alcohol Use Disorders

    • Richard Saitz
    Ann Intern Med May 4, 1999 130:779

  • Screening Tests for Alcohol Use Disorders

    • Robert J. Volk,
    • Scott B. Cantor,
    • and Jeffrey R. Steinbauer
    Ann Intern Med May 4, 1999 130:779-780

  • Genetics of Familial Mediterranean Fever

    • Paul I. Roda
    Ann Intern Med May 4, 1999 130:780

  • Genetics of Familial Mediterranean Fever

    • Mark Levin
    Ann Intern Med May 4, 1999 130:780

  • Genetics of Familial Mediterranean Fever

    • George E. Ehrlich
    Ann Intern Med May 4, 1999 130:780-781

  • How Physicians Communicate about Advance Directives

    • Bruce Leff
    Ann Intern Med May 4, 1999 130:781

  • How Physicians Communicate about Advance Directives

    • Jean R. Pascoe
    Ann Intern Med May 4, 1999 130:781

  • How Physicians Communicate about Advance Directives

    • James A. Tulsky,
    • Gary S. Fischer,
    • and Robert M. Arnold
    Ann Intern Med May 4, 1999 130:781

Medical Writings

  • Textbook Geriatrics: Not Yet of the Essence

    • Thomas E. Finucane and
    • Timothy S. Loo
    Ann Intern Med May 4, 1999 130:782-786

    Three major geriatrics textbooks are reviewed in an attempt to infer how editors and authors see the field of geriatrics and how well they grapple with the complexity of caring for the frail elderly.

Medical Writings: Book Notes

Ad Libitum

Book Listings

Medical Notices

  • Medical Notices

    Ann Intern Med May 4, 1999 130:0
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This Issue

May 4, 1999; 130 (9)
  1. Articles
  2. Brief Communications
  3. Academia and Clinic
  4. Review
  5. NIH Conferences
  6. Editorials
  7. On Being a Doctor
  8. Letters
  9. Medical Writings
  10. Medical Writings: Book Notes
  11. Ad Libitum
  12. Book Listings
  13. Medical Notices

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