Table of Contents

September 21, 1999; 131 (6)

Articles

  • Paroxysmal Nocturnal Hemoglobinuria Cells in Patients with Bone Marrow Failure Syndromes

    • Daniel E. Dunn,
    • Patcharin Tanawattanacharoen,
    • Piernicola Boccuni,
    • Shoichi Nagakura,
    • Spencer W. Green,
    • Martha R. Kirby,
    • Mysore S. Anil Kumar,
    • Stephen Rosenfeld,
    • and Neal S. Young
    Ann Intern Med September 21, 1999 131:401-408

    Flow cytometric analysis is superior to the Ham test and permits concomitant diagnosis of paroxysmal nocturnal hemoglobinuria in about 20% of patients with myelodysplasia (a rate similar to that seen in patients with aplastic anemia). In myelodysplasia, the presence of cells that are deficient in glycosylphosphatidylinositol-anchored protein predicts responsiveness to immunosuppressive therapy.

  • Use of Complementary Therapies for Arthritis among Patients of Rheumatologists

    • Jaya K. Rao,
    • Kimberly Mihaliak,
    • Kurt Kroenke,
    • John Bradley,
    • William M. Tierney,
    • and Morris Weinberger
    Ann Intern Med September 21, 1999 131:409-416

    Patients with rheumatologic conditions frequently use complementary and alternative medicine (CAM). Severe pain and osteoarthritis predict regular use of CAM but do not predict a greater likelihood that a patient will discuss CAM use with physicians.

  • Clinical Utility of a Rapid Whole-Blood D-Dimer Assay in Patients with Cancer Who Present with Suspected Acute Deep Venous Thrombosis

    • Agnes Y.Y. Lee,
    • Jim A. Julian,
    • Mark N. Levine,
    • Jeffrey I. Weitz,
    • Clive Kearon,
    • Philip S. Wells,
    • and Jeffrey S. Ginsberg
    Ann Intern Med September 21, 1999 131:417-423

    A negative D-dimer test result in patients with cancer does not reliably exclude deep venous thrombosis because the negative predictive value of the test is significantly lower in these patients than in patients without cancer.

  • Fire Ant Attacks on Residents in Health Care Facilities: A Report of Two Cases

    • Richard D. deShazo,
    • David F. Williams,
    • and Edward S. Moak
    Ann Intern Med September 21, 1999 131:424-429

    Imported fire ants now infest more than 310 million acres in the United States and Puerto Rico. With the two cases reported here, the total number of reported indoor fire ant attacks on humans since 1989 is 10. Eight of these attacks have been reported in the past 4 years.

Brief Communications

  • Efficacy of Influenza Vaccination in HIV-Infected Persons: A Randomized, Double-Blind, Placebo-Controlled Trial

    • Sybil A. Tasker,
    • John J. Treanor,
    • William B. Paxton,
    • and Mark R. Wallace
    Ann Intern Med September 21, 1999 131:430-433

    Influenza vaccination is highly effective in HIV-1–infected patients and does not seem to be associated with substantial changes in viral load or CD4 cell count.

  • Azithromycin Compared with Penicillin G Benzathine for Treatment of Incubating Syphilis

    • Edward W. Hook III,
    • Joan Stephens,
    • and David M. Ennis
    Ann Intern Med September 21, 1999 131:434-437

    A single 1.0-g dose of azithromycin seems to be efficacious for preventing syphilis in the sexual partners of infected persons.

Academia and Clinic

  • Innovative Thinking for the Improvement of Medical Systems

    • Paul Plsek
    Ann Intern Med September 21, 1999 131:438-444

    Health care systems that do not deliver the desired results must be changed in some way. This paper describes ways to spark innovative thinking and generate creative ideas for health care system improvement.

Updates

  • Therapeutic Plasma Exchange: An Update from the Canadian Apheresis Group

    • William F. Clark,
    • Gail A. Rock,
    • Noel Buskard,
    • Kenneth H. Shumak,
    • Pierre LeBlond,
    • David Anderson,
    • David M. Sutton,
    • and for the Canadian Apheresis Group*
    Ann Intern Med September 21, 1999 131:453-462

    In 1997, the Canadian Apheresis Group reviewed data on 103 416 plasma exchange procedures that had been collected since 1980. Striking changes occurred over time in the frequency of use of apheresis, particularly for thrombotic thrombocytopenic purpura, myasthenia gravis, rheumatoid arthritis, and multiple sclerosis. In most instances, changes in the frequency of apheresis use correlated closely with published evidence on efficacy.

Perspectives

  • The HERS Trial Results: Paradigms Lost?

    • David M. Herrington
    Ann Intern Med September 21, 1999 131:463-466

    The Heart and Estrogen/progestin Replacement Study (HERS) showed no overall effect of long-term use of estrogen plus progestin for secondary prevention of coronary heart disease in postmenopausal women. The key to understanding this finding, which contradicts previous research, may rest in the explanation of the time-trend data.

Editorial

  • Clonal Variation, Autoimmunity, and Neoplasia: An Ecology Lesson from Paroxysmal Nocturnal Hemoglobinuria

    • Edward J. Benz, Jr.
    Ann Intern Med September 21, 1999 131:467-468

    Cancer occurring in immunodeficient states is attributed to loss of immune surveillance. In this issue, Dunn and colleagues propose that immune attack might actually confer an ecological advantage on some neoplastic cells in their microenvironment.

On Being a Doctor

  • Learning Medicine through the Closet Door

    • J. Randall Curtis
    Ann Intern Med September 21, 1999 131:470-471

    The first call night of my third year of medical school wasn't the first time that I had felt intensely uncomfortable because of homophobic comments, but it was the most memorable.

On Being a Patient

  • The Pirates

    • Campion Quinn
    Ann Intern Med September 21, 1999 131:472-473

    Two boys at play discover a real weapon among their imaginary ones.

Letters

  • Clinical Model for Management of Pulmonary Embolism

    • Jeffrey Pickard
    Ann Intern Med September 21, 1999 131:474

  • Clinical Model for Management of Pulmonary Embolism

    • John F. Whitney
    Ann Intern Med September 21, 1999 131:474

  • Clinical Model for Management of Pulmonary Embolism

    • Stephen J. Jay
    Ann Intern Med September 21, 1999 131:474-475

  • Clinical Model for Management of Pulmonary Embolism

    • Paul Egermayer
    Ann Intern Med September 21, 1999 131:475

  • Clinical Model for Management of Pulmonary Embolism

    • Philip Wells,
    • David Anderson,
    • and Jeffrey Ginsberg
    Ann Intern Med September 21, 1999 131:475

  • Hemochromatosis and Vitamin C

    • Victor Herbert
    Ann Intern Med September 21, 1999 131:475-476

  • Hemochromatosis and Vitamin C

    • James C. Barton,
    • Paul C. Adams,
    • and Lawrie W. Powell
    Ann Intern Med September 21, 1999 131:476

  • ACI-TIPI Clinical Trial

    • Kevin P. Weinfurt,
    • Saif S. Rathore,
    • and Kevin A. Schulman
    Ann Intern Med September 21, 1999 131:476-477

  • ACI-TIPI Clinical Trial

    • Harry P. Selker,
    • John L. Griffith,
    • and Joni R. Beshansky
    Ann Intern Med September 21, 1999 131:477

  • Myocardial Abscess with Salmonella Infection

    • J. Recio,
    • J. Alegre,
    • and T. Fernández de Sevilla
    Ann Intern Med September 21, 1999 131:477-478

  • Solid Organ Transplantation

    • Lloyd E. Ratner,
    • Robert A. Montgomery,
    • and Louis R. Kavoussi
    Ann Intern Med September 21, 1999 131:478

Medical Writings: Book Notes

  • Clinical Infectious Disease: A Practical Approach

    • Steven L. Berk and
    • James W. Myers
    Ann Intern Med September 21, 1999 131:479

  • Pocket Guide to Vaccination and Prophylaxis

    • Donald J. Kennedy
    Ann Intern Med September 21, 1999 131:479-480

  • Vaccines

    • Gordon Douglas, Jr.
    Ann Intern Med September 21, 1999 131:480

  • Sexually Transmitted Diseases: A Physician Tells You What You Need to Know

    • J. Dennis Fortenberry
    Ann Intern Med September 21, 1999 131:480

Currents

  • Rapid Testing for HIV: Why So Fast?

    • Brigid Kane
    Ann Intern Med September 21, 1999 131:481-483

  • The Financial Costs of Gun Violence

    • Linda Gunderson
    Ann Intern Med September 21, 1999 131:483-484

Ad Libitum

Book Listings

Medical Notices

  • Medical Notices

    Ann Intern Med September 21, 1999 131:0

Updates from the Annual Session

  • Update in Gastroenterology

    • Norton J. Greenberger
    Ann Intern Med September 21, 1999 131:445-452

    Among the most important topics attracting researchers' attention in 1998 were gastroesophageal reflux disease, the diagnosis and treatment of Helicobacter pylori infection, and the best management of patients with nonulcer dyspepsia.

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This Issue

September 21, 1999; 131 (6)
  1. Articles
  2. Brief Communications
  3. Academia and Clinic
  4. Updates
  5. Perspectives
  6. Editorial
  7. On Being a Doctor
  8. On Being a Patient
  9. Letters
  10. Medical Writings: Book Notes
  11. Currents
  12. Ad Libitum
  13. Book Listings
  14. Medical Notices
  15. Updates from the Annual Session

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