Table of Contents

March 16, 2004; 140 (6)

Articles

  • Patients will probably respond more favorably to physicians who fully disclose medical errors than to physicians who are less forthright, but the specifics of the case and the severity of the clinical outcome are also important. In some circumstances, full disclosure won't deter patients from seeking legal advice.

  • Routine culture for Staphylococcus aureus nasal carriage at hospital admission followed by intranasal mupirocin treatment of colonized patients does not prevent nosocomial S. aureus infections in nonsurgical patients.

  • Ethnicity, body weight, and level of nicotine dependence may help to predict which smokers will achieve long-term abstinence with either transdermal or nasal spray nicotine.

  • It is difficult to interpret a family history of cardiovascular disease because the accuracy of patient reports of family history is unknown. Using Framingham Heart Study data spanning 2 generations, the authors compared patient reports of parental history with their parents' Framingham Study records. A positive family history item is probably accurate and a negative family history item is often inaccurate.

Updates

  • This first Update in Perioperative Medicine reviews recent key articles and advances in the following areas: cardiac risk stratification and risk reduction strategies, preoperative pulmonary evaluation, venous thromboembolism prophylaxis, diabetes mellitus, and postoperative delirium.

Review

  • Several distinct types of pain exist: nociceptive, inflammatory, neuropathic, and functional. By defining the mechanisms responsible for each type of pain, neurophysiologic research is providing insight into how diverse etiologic factors cause different types of pain.

Clinical Guidelines

  • The U.S. Preventive Services Task Force recommends against routine screening for hepatitis C virus infection in asymptomatic adults who are not at increased risk for infection. The Task Force found insufficient evidence to recommend for or against routine screening of adults at high risk for hepatitis C virus infection.

  • Screening tests can detect hepatitis C virus, and antiviral treatment can eradicate the virus. However, long-term outcomes of treating patients identified by screening are not known, and therefore the available evidence is inadequate to accurately weigh the overall benefits and risks of screening healthy asymptomatic adults.

Editorials

  • This issue of Annals is the first in which the abstracts include a section on study limitations. We believe that a statement of study limitations in the abstract will help readers to understand the meaning and implications of every article.

  • A study in this issue indicates that lawyers, physicians, and patients might all benefit from more dialogue about disclosing medical error. These conversations might tell us that a few well-chosen, well-spoken, and well-timed words have the power to heal some of the damage caused by medical error.

  • A study reported in this issue indicates that general inpatient populations, even if screened and selected for Staphylococcus aureus nasal colonization, do not benefit from intranasal mupirocin. Whether other dosing regimens would be effective for high-risk colonized patients remains to be seen.

Letters

Medical Writings: Book Notes

Current Clinical Issues

Ad Libitum

Book Listings

Medical Notices

Summaries for Patients