Table of Contents

March 18, 2003; 138 (6)

Articles

  • Implantable Cardioverter Defibrillators in Primary and Secondary Prevention: A Systematic Review of Randomized, Controlled Trials

    • Justin A. Ezekowitz,
    • Paul W. Armstrong,
    • and Finlay A. McAlister
    Ann Intern Med March 18, 2003 138:445-452

    Implantable cardioverter defibrillators prevent sudden cardiac death regardless of baseline risk. However, their impact on total mortality is sensitive to baseline risk for arrhythmic death. Decisions about resource allocation for these devices depend on accurate stratification of patients according to risk.

  • High Prevalence of Anal Human Papillomavirus Infection and Anal Cancer Precursors among HIV-Infected Persons in the Absence of Anal Intercourse

    • Christophe Piketty,
    • Teresa M. Darragh,
    • Maria Da Costa,
    • Patrick Bruneval,
    • Isabelle Heard,
    • Michel D. Kazatchkine,
    • and Joel M. Palefsky
    Ann Intern Med March 18, 2003 138:453-459

    HIV-positive men may acquire anal human papillomavirus infection and anal squamous intraepithelial lesions in the absence of anal intercourse. All HIV-positive men with CD4+cell counts less than 500 × 106 cells/L, regardless of history of anal intercourse, should be considered for anal cytologic screening; however, the efficacy of this procedure to prevent anal cancer in these populations is unknown.

  • The Impact of Protein Intake on Renal Function Decline in Women with Normal Renal Function or Mild Renal Insufficiency

    • Eric L. Knight,
    • Meir J. Stampfer,
    • Susan E. Hankinson,
    • Donna Spiegelman,
    • and Gary C. Curhan
    Ann Intern Med March 18, 2003 138:460-467

    High protein intake was not associated with renal function decline in women with normal renal function. However, high total protein intake, particularly of nondairy animal protein, may accelerate renal function decline in women with mild renal insufficiency.

Brief Communications

  • The Relative Safety of Ephedra Compared with Other Herbal Products

    • Stephen Bent,
    • Thomas N. Tiedt,
    • Michelle C. Odden,
    • and Michael G. Shlipak
    Ann Intern Med March 18, 2003 138:468-471

    Ephedra (ma huang) use is associated with a greatly increased risk for adverse reactions compared with other herbs, and its use should be restricted.

  • Support for Physician Deception of Insurance Companies among a Sample of Philadelphia Residents

    • G Caleb Alexander,
    • Rachel M. Werner,
    • Angela Fagerlin,
    • and Peter A. Ubel
    Ann Intern Med March 18, 2003 138:472-475

    A substantial number of the prospective jurors interviewed in this study sanctioned physicians' deception of insurance companies to obtain coverage for a needed service.

Academia and Clinic

  • The Mini-CEX: A Method for Assessing Clinical Skills

    • John J. Norcini,
    • Linda L. Blank,
    • F Daniel Duffy,
    • and Gregory S. Fortna
    Ann Intern Med March 18, 2003 138:476-481

    In the mini–clinical evaluation exercise (mini-CEX), a faculty member evaluates a resident's care for a patient during a 15- to 20-minute visit several times a year. The mini-CEX offers an assessment process based on a broad set of patients, clinical settings, and patient problems.

Reviews

  • Evaluation of 21st-Century Risks of Smallpox Vaccination and Policy Options

    • J. Michael Lane and
    • Joel Goldstein
    Ann Intern Med March 18, 2003 138:488-493

    The authors describe the smallpox vaccine, review risks from vaccination, estimate the actual number of deaths from vaccination that might occur after widespread vaccination today, comment on risk for smallpox spread from a bioterrorism attack, and discuss options for preattack vaccination policy.

  • Prevention of Ventilator-Associated Pneumonia: An Evidence-Based Systematic Review

    • Harold R. Collard,
    • Sanjay Saint,
    • and Michael A. Matthay
    Ann Intern Med March 18, 2003 138:494-501

    The authors recommend considering several interventions to reduce the incidence of ventilator-associated pneumonia: semi-recumbent positioning, sucralfate rather than H2-antagonists in patients at low to moderate risk for gastrointestinal tract bleeding, aspiration of subglottic secretions, and oscillating beds. They do not recommend selective digestive tract decontamination because routine use may increase antimicrobial resistance.

Perspectives

  • A New Paradigm for the Treatment of Sepsis: Is It Time To Consider Combination Therapy?

    • Alan S. Cross and
    • Steven M. Opal
    Ann Intern Med March 18, 2003 138:502-505

    It is time to test a new therapeutic paradigm for sepsis based on an improved understanding of the pathophysiology of the septic process and the recognition that we may have reached the limits of monotherapy.

  • Cardiac Events in Patients Undergoing Noncardiac Surgery: Shifting the Paradigm from Noninvasive Risk Stratification to Therapy

    • Paul A. Grayburn and
    • L David Hillis
    Ann Intern Med March 18, 2003 138:506-511

    The paradigm is shifting from predicting which patient is at high risk for a perioperative cardiac event to minimizing the likelihood of such an event with specific perioperative pharmacologic therapy.

Editorial

  • The Clinical Use of Implantable Cardioverter Defibrillators: Where Are We Now? Where Should We Go?

    • Alfred E. Buxton
    Ann Intern Med March 18, 2003 138:512-514

    In this issue, Ezekowitz and colleagues summarize mortality data from eight recent trials of implantable cardioverter defibrillators. Although the patients included in these studies (coronary disease and ejection fraction < 0.3) were at high risk for sudden death, more than 56% of patients with myocardial infarction who later die suddenly have an ejection fraction greater than 0.3. The real challenge lies in identifying potential victims in this large reservoir of lower-risk patients.

On Being a Doctor

  • Them and Us

    • Elisha H. Atkins
    Ann Intern Med March 18, 2003 138:515-516

    At the small city hospital where I trained, “they” were us. When I went to work in a health center in another, poorer city, I made every attempt to establish common ground with my patients, but it required work, extrapolation, straining across a growing gap of language, culture, and circumstance. No one required more work than Nora and her family.

Letters

  • Tests of Glycemia

    • Mayer B. Davidson
    Ann Intern Med March 18, 2003 138:517

  • Tests of Glycemia

    • R Graham Barr,
    • James B. Meigs,
    • and Daniel E. Singer
    Ann Intern Med March 18, 2003 138:517

  • The Wrong Patient

    • Stephen Sandroni
    Ann Intern Med March 18, 2003 138:517-518

  • The Wrong Patient

    • Linda Fermoyle Rice
    Ann Intern Med March 18, 2003 138:518

  • The Wrong Patient

    • James G. Gallagher
    Ann Intern Med March 18, 2003 138:518

  • The Wrong Patient

    • Robert M. Wachter,
    • Kaveh G. Shojania,
    • Sanjay Saint,
    • Amy J. Markowitz,
    • and Mark Smith
    Ann Intern Med March 18, 2003 138:518-519

  • Bad Outcomes of Questionable Medical Decisions

    • Kenneth M. Kessler
    Ann Intern Med March 18, 2003 138:519

  • Bad Outcomes of Questionable Medical Decisions

    • Elizabeth Nilson
    Ann Intern Med March 18, 2003 138:519-520

  • Bad Outcomes of Questionable Medical Decisions

    • William B. Weeks and
    • James P. Bagian
    Ann Intern Med March 18, 2003 138:520

  • Bad Outcomes of Questionable Medical Decisions

    • Timothy P. Hofer and
    • Rodney A. Hayward
    Ann Intern Med March 18, 2003 138:520

  • A Novel Defect in Interferon-γ Secretion in Patients with Refractory Nontuberculous Pulmonary Mycobacteriosis

    • Amar Safdar,
    • Donald Armstrong,
    • and Henry W. Murray
    Ann Intern Med March 18, 2003 138:521

  • Myiasis in a Traveler: A Moving Story

    • Joshua P. Fogelman,
    • Doris J. Day,
    • and Robert J. Cohen
    Ann Intern Med March 18, 2003 138:521-522

  • Hypercalcemia after 1,25-Dihydroxyvitamin D3 Production in an End-Stage Kidney

    • Robert W. Hedger,
    • Eberechukwu Ibe,
    • and Arleen French
    Ann Intern Med March 18, 2003 138:522-523

Medical Writings: Book and Software Notes

  • Hospital Medicine Essentials for PDA. Version 5.0

    • J. Marc Overhage and
    • Paul Dexter
    Ann Intern Med March 18, 2003 138:524

  • Essentials of Medical Genomics

    • Raymond R. Townsend
    Ann Intern Med March 18, 2003 138:524

Book Listings

Medical Notices

Summaries for Patients

  • Who Benefits from Implantable Heart Defibrillators?

    Ann Intern Med March 18, 2003 138:I-40

  • Anal Cancer Precursors in Persons with HIV Infection

    Ann Intern Med March 18, 2003 138:I-44

  • The Effect of Dietary Protein Intake on Kidney Function in Women with Normal or Mildly Abnormal Kidneys

    Ann Intern Med March 18, 2003 138:I-51

  • Ephedra Is Associated with More Adverse Effects than Other Herbs

    Ann Intern Med March 18, 2003 138:I-56

  • Opinions about Doctors Deceiving Insurance Companies To Obtain Health Services for Their Patients

    Ann Intern Med March 18, 2003 138:I-62

  • Ventilator-Associated Pneumonia

    Ann Intern Med March 18, 2003 138:I-67

Updates from the Annual Session

  • Update in Cardiology

    • Peter H. Stone
    Ann Intern Med March 18, 2003 138:482-487

    The author discusses unstable coronary artery disease; treatments of chronic coronary artery disease; risk factors for atherosclerotic cardiovascular disease; management of heart failure; valvular disease; peripheral vascular disease; and arrhythmia.

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This Issue

March 18, 2003; 138 (6)
  1. Articles
  2. Brief Communications
  3. Academia and Clinic
  4. Reviews
  5. Perspectives
  6. Editorial
  7. On Being a Doctor
  8. Letters
  9. Medical Writings: Book and Software Notes
  10. Book Listings
  11. Medical Notices
  12. Summaries for Patients
  13. Updates from the Annual Session

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