Table of Contents

December 16, 2003; 139 (12)

Articles

  • Using Risk for Advanced Proximal Colonic Neoplasia To Tailor Endoscopic Screening for Colorectal Cancer

    • Thomas F. Imperiale,
    • David R. Wagner,
    • Ching Y. Lin,
    • Gregory N. Larkin,
    • James D. Rogge,
    • and David F. Ransohoff
    Ann Intern Med December 16, 2003 139:959-965

    A clinical prediction rule incorporating age, sex, and endoscopic findings within reach of a flexible sigmoidoscope identified a subgroup at very low risk for advanced neoplasia in the proximal colon. If the prediction rule consistently identifies a group at similarly low risk in other cohorts of patients, it could be the basis for selecting patients for endoscopic screening for colorectal cancer.

  • Sunscreen Use and the Risk for Melanoma: A Quantitative Review

    • Leslie K. Dennis,
    • Laura E. Beane Freeman,
    • and Marta J. VanBeek
    Ann Intern Med December 16, 2003 139:966-978

    Despite earlier reports that sunscreen use was associated with melanoma, the authors found no evidence in the published literature for this association. Previous studies that showed an association between sunscreen use and melanoma risk may have failed to control for factors that influence both sunscreen use and the risk for melanoma.

  • Chest Pain Relief by Nitroglycerin Does Not Predict Active Coronary Artery Disease

    • Charles A. Henrikson,
    • Eric E. Howell,
    • David E. Bush,
    • J. Shawn Miles,
    • Glenn R. Meininger,
    • Tracy Friedlander,
    • Andrew C. Bushnell,
    • and Nisha Chandra-Strobos
    Ann Intern Med December 16, 2003 139:979-986

    Contrary to common belief, relief of chest pain with nitroglycerin did not predict active coronary artery disease in patients admitted for acute chest pain.

Improving Patient Care

  • Triage of Patients with Acute Chest Pain and Possible Cardiac Ischemia: The Elusive Search for Diagnostic Perfection

    • Lee Goldman and
    • Ajay J. Kirtane
    Ann Intern Med December 16, 2003 139:987-995

    The basis of this article is a patient who was sent home from the emergency department after presenting with chest pain. Later events proved that the patient had a myocardial infarction. The authors discuss the diagnosis and triage of patients presenting with acute chest pain or with symptoms consistent with possible cardiac ischemia.

Review

  • Varying Cost and Free Nicotinic Acid Content in Over-the-Counter Niacin Preparations for Dyslipidemia

    • C. Daniel Meyers,
    • Molly C. Carr,
    • Sang Park,
    • and John D. Brunzell
    Ann Intern Med December 16, 2003 139:996-1002

    No-flush niacin preparations that do not require a prescription for purchase do not contain any free nicotinic acid and are without value for treating dyslipidemia. Sustained-release niacin available without prescription does contain free nicotinic acid, but some brands are hepatotoxic. Immediate-release niacin contains free nicotinic acid and is the least expensive form of over-the-counter niacin.

Clinical Guidelines

  • Management of Newly Detected Atrial Fibrillation: A Clinical Practice Guideline from the American Academy of Family Physicians and the American College of Physicians

    • Vincenza Snow,
    • Kevin B. Weiss,
    • Michael LeFevre,
    • Robert McNamara,
    • Eric Bass,
    • Lee A. Green,
    • Keith Michl,
    • Douglas K. Owens,
    • Jeffrey Susman,
    • Deborah I. Allen,
    • Christel Mottur-Pilson,
    • and the Joint AAFP/ACP Panel on Atrial Fibrillation
    Ann Intern Med December 16, 2003 139:1009-1017

    This paper summarizes the recommendations of the Joint Panel of the American Academy of Family Physicians and the American College of Physicians for managing a first episode of atrial fibrillation in adults.

  • Management of Atrial Fibrillation: Review of the Evidence for the Role of Pharmacologic Therapy, Electrical Cardioversion, and Echocardiography

    • Robert L. McNamara,
    • Leonardo J. Tamariz,
    • Jodi B. Segal,
    • and Eric B. Bass
    Ann Intern Med December 16, 2003 139:1018-1033

    This review, which supports the recommendations of the American Academy of Family Physicians and the American College of Physicians, summarizes the available evidence about the efficacy of medications used for ventricular rate control, stroke prevention, acute rhythm conversion, and maintenance of sinus rhythm. The review also discusses the efficacy of electrical cardioversion and the use of echocardiography in patients with atrial fibrillation.

Editorials

  • Screening Sigmoidoscopy: Can the Road to Colonoscopy Be Less Traveled?

    • Sidney J. Winawer
    Ann Intern Med December 16, 2003 139:1034-1035

    In this issue, Imperiale and colleagues take a systematic approach to examining clinical and flexible sigmoidoscopy findings that identify patients who have the lowest risk for advanced adenomas in the proximal colon. Their findings suggest a screening colonoscopy strategy that makes the best use of the test's high diagnostic accuracy and avoids exposure to its expense, inconvenience, and risk when the predicted yield is low. Whether this strategy will conserve resources remains to be determined.

  • Nitroglycerin: Should We Still Ask?

    • Raymond J. Gibbons
    Ann Intern Med December 16, 2003 139:1036-1037

    The study by Henrikson and colleagues in this issue is an important addition to the evidence on the diagnostic value of chest pain relief by nitroglycerin. The response to sublingual nitroglycerin had no diagnostic value in patients who developed chest pain (presumably at rest) under medical supervision after admission. Do these findings mean that we should stop using the response to nitroglycerin to help diagnose patients with chronic chest pain?

  • Peer Review: Integral to Science and Indispensable to Annals

    • Christine Laine,
    • Cynthia Mulrow,
    • and for the Editors
    Ann Intern Med December 16, 2003 139:1038-1040

    In this issue, Annals salutes the individuals who reviewed manuscripts over the past year. This editorial reflects on the value, quality, and future of peer review.

On Being a Doctor

  • A Christmas Story

    • Ted Louie
    Ann Intern Med December 16, 2003 139:1041

    In my second year of private practice, as the junior partner, I expected to be on call on Christmas. That was only fair, it seemed. But it didn't seem all that fair when Christmas Day actually came around. There I was, in the hospital, doing consultations and seemingly endless rounds, as the rest of the world enjoyed the day in the company of family and friends.

  • A Chapel for Christmas

    • Louis D. Boshes
    Ann Intern Med December 16, 2003 139:1042

    It was early on Christmas Eve, 24 December 1943, and I was far away from home on duty at a U.S. Navy medical facility. I had always requested duty on holidays to cover for my medical buddies who were not of my own faith, and they did the same for me. My patients were a large group of 17-, 18-, and 19-year-old Marines fresh off Guadalcanal, where they had aged so rapidly in combat with enemies and tropical illnesses. They were truly ill, both physically and emotionally.

Letters

  • Defibrillators and Sudden Death

    • Lawrence J. Cohn
    Ann Intern Med December 16, 2003 139:W-84

  • Defibrillators and Sudden Death

    • Justin A. Ezekowitz,
    • Finlay A. McAlister,
    • and Paul W. Armstrong
    Ann Intern Med December 16, 2003 139:W-85

  • Subacute Painful Quadriplegia and Purpura

    • A. M. Huisman,
    • M. F. van der Meulen,
    • T. W.M. Raaymakers,
    • M. R. Canninga-van Dijk,
    • J. W.J. Bijlsma,
    • and A. Coremans
    Ann Intern Med December 16, 2003 139:W-86

  • Postmenopausal Hormones and Glycemic Effects

    • John V.L. Sheffield and
    • Eric B. Larson
    Ann Intern Med December 16, 2003 139:1043

  • Postmenopausal Hormones and Glycemic Effects

    • John P. Girod and
    • Daniel J. Brotman
    Ann Intern Med December 16, 2003 139:1043

  • Postmenopausal Hormones and Glycemic Effects

    • Aidan McElduff
    Ann Intern Med December 16, 2003 139:1043-1044

  • Postmenopausal Hormones and Glycemic Effects

    • Alka M. Kanaya,
    • David Herrington,
    • and Elizabeth Barrett-Connor
    Ann Intern Med December 16, 2003 139:1044

  • Acute Liver Failure in the United States

    • William D. Carey
    Ann Intern Med December 16, 2003 139:1044-1045

  • Acute Liver Failure in the United States

    • Raquel Marie Schears
    Ann Intern Med December 16, 2003 139:1045

  • Acute Liver Failure in the United States

    • William M. Lee,
    • Anne Larson,
    • Robert Fontana,
    • and George Ostapowicz
    Ann Intern Med December 16, 2003 139:1045-1046

  • Culture of Tropheryma whippelii from the Vitreous Fluid of a Patient Presenting with Unilateral Uveitis

    • Michel Drancourt,
    • Didier Raoult,
    • Hubert Lépidi,
    • Florence Fénollar,
    • Marie-Laure Birg,
    • Bahram Bodaghi,
    • Phuc Le Hoang,
    • and Jean-Daniel Lelièvre
    Ann Intern Med December 16, 2003 139:1046-1047

Medical Writings: Book Notes

Thanks to Reviewers

Book Listings

  • Book Listings

    Ann Intern Med December 16, 2003 139:0

Medical Notices

  • Medical Notices

    Ann Intern Med December 16, 2003 139:0

Summaries for Patients

  • Using Risks To Tailor Screening for Colorectal Cancer

    Ann Intern Med December 16, 2003 139:I-10

  • Sunscreen Use and Melanoma

    Ann Intern Med December 16, 2003 139:I-16

  • Does Chest Pain Relief with Nitroglycerin Mean Coronary Artery Disease?

    Ann Intern Med December 16, 2003 139:I-30

  • Management of Newly Detected Atrial Fibrillation: Recommendations from the American College of Physicians and the American Academy of Family Physicians

    Ann Intern Med December 16, 2003 139:I-32

Updates from the Annual Session

  • Update in Geriatric Medicine

    • Rosanne M. Leipzig
    Ann Intern Med December 16, 2003 139:1003-1008

    This Update focuses on a variety of topics in the field: disease prevention and health promotion, cognitive training, physical exercise, glaucoma prevention, cardiovascular disease, and late-life depression.

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This Issue

December 16, 2003; 139 (12)
  1. Articles
  2. Improving Patient Care
  3. Review
  4. Clinical Guidelines
  5. Editorials
  6. On Being a Doctor
  7. Letters
  8. Medical Writings: Book Notes
  9. Thanks to Reviewers
  10. Book Listings
  11. Medical Notices
  12. Summaries for Patients
  13. Updates from the Annual Session

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