Table of Contents

November 16, 2004; 141 (10)

Articles

  • Advanced Age, Anticoagulation Intensity, and Risk for Intracranial Hemorrhage among Patients Taking Warfarin for Atrial Fibrillation

    • Margaret C. Fang,
    • Yuchiao Chang,
    • Elaine M. Hylek,
    • Jonathan Rosand,
    • Steven M. Greenberg,
    • Alan S. Go,
    • and Daniel E. Singer
    Ann Intern Med November 16, 2004 141:745-752

    The risk for intracranial hemorrhage increases at age 85 years. In this study, international normalized ratios (INRs) less than 2.0 and INRs of 2.0 to 3.0 were associated with the same risk for intracranial hemorrhage. The risk increases with INRs of 3.5 or greater. Therefore, in elderly patients with atrial fibrillation, clinicians should maintain INRs in the 2.0 to 3.0 range.

  • Comparison of Endoscopic Ultrasonography and Multidetector Computed Tomography for Detecting and Staging Pancreatic Cancer

    • John DeWitt,
    • Benedict Devereaux,
    • Melissa Chriswell,
    • Kathleen McGreevy,
    • Thomas Howard,
    • Thomas F. Imperiale,
    • Donato Ciaccia,
    • Kathleen A. Lane,
    • Dean Maglinte,
    • Kenyon Kopecky,
    • Julia LeBlanc,
    • Lee McHenry,
    • James Madura,
    • Alex Aisen,
    • Harvey Cramer,
    • Oscar Cummings,
    • and Stuart Sherman
    Ann Intern Med November 16, 2004 141:753-763

    Accurate preoperative detection and precise staging of pancreatic cancer may identify patients with surgically curable locoregional disease. Endoscopic ultrasonography is superior to multidetector computed tomography for detecting and staging tumors. The tests have equivalent accuracy for nodal staging and detecting nonmetastatic pancreatic cancer that is resectable.

  • Taking Glucocorticoids by Prescription Is Associated with Subsequent Cardiovascular Disease

    • Li Wei,
    • Thomas M. MacDonald,
    • and Brian R. Walker
    Ann Intern Med November 16, 2004 141:764-770

    In this population-based study, patients receiving dosages of glucocorticoids greater than the equivalent of 7.5 mg of prednisolone per day had substantially higher 1- to 5-year rates of all cardiovascular diseases, including myocardial infarction, heart failure, and cerebrovascular disease.

Improving Patient Care

  • Measuring the Quality of Physician Practice by Using Clinical Vignettes: A Prospective Validation Study

    • John W. Peabody,
    • Jeff Luck,
    • Peter Glassman,
    • Sharad Jain,
    • Joyce Hansen,
    • Maureen Spell,
    • and Martin Lee
    Ann Intern Med November 16, 2004 141:771-780

    This study shows that vignettes are a valid tool for measuring the quality of clinical practice. They are particularly useful for evaluating quality when practice-based assessment is difficult because of differences in case mix between physicians.

  • Better Reporting of Harms in Randomized Trials: An Extension of the CONSORT Statement

    • John P.A. Ioannidis,
    • Stephen J.W. Evans,
    • Peter C. Gøtzsche,
    • Robert T. O'Neill,
    • Douglas G. Altman,
    • Kenneth Schulz,
    • David Moher,
    • and for the CONSORT Group*
    Ann Intern Med November 16, 2004 141:781-788

    The CONSORT (Consolidated Standards of Reporting Trials) statement is a guideline for writing reports of randomized, controlled trials. Starting with the standard CONSORT checklist, the authors add 10 new recommendations for how to report harms observed during clinical trials.

Updates

  • Update in Rheumatology

    • David B. Hellmann
    Ann Intern Med November 16, 2004 141:801-804

    This Update incorporates articles on vasculitis, rheumatoid arthritis, the antiphospholipid antibody syndrome, systemic lupus erythematosus, and osteoarthritis.

  • Update on the Health Disparities Literature

    • Judith A. Long,
    • Virginia W. Chang,
    • Said A. Ibrahim,
    • and David A. Asch
    Ann Intern Med November 16, 2004 141:805-812

    Underrepresented minorities in the United States are likely to have worse health and receive less health care than the racial and ethnic majority. This Update focuses on studies that document disparities, explain disparities, and test strategies to reduce disparities.

Review

  • The Physiologic Basis of High-Altitude Diseases

    • John B. West
    Ann Intern Med November 16, 2004 141:789-800

    This review discusses the relationship of altitude to barometric pressure, effects of the hypoxia of high altitude, acclimatization to high altitude, improving working efficiency at high altitude, physiologic changes at extreme altitudes, and high-altitude diseases.

Editorials

  • Back to the Future: Clinical Vignettes and the Measurement of Physician Performance

    • John Norcini
    Ann Intern Med November 16, 2004 141:813-814

    The study by Peabody and colleagues builds on a large body of research on clinical vignettes and moves the field forward by showing that performance on clinical vignettes is similar to actual practice caring for matched cases. The value of this method depends on whether physicians will make the same management decisions for the problem posed in the vignette as they do in their daily practice.

  • Inequality in Health Care: Unjust, Inhumane, and Unattended!

    • Talmadge E. King, Jr and
    • Margaret B. Wheeler
    Ann Intern Med November 16, 2004 141:815-817

    The U.S. health care system remains largely separate and unequal. Mounting evidence shows that unequal health care based on race and ethnicity is pervasive and clinically significant. In this issue, Long and colleagues review the recent health and health care disparities literature and summarize selected articles that can help to direct our search for answers.

On Being a Doctor

  • Medicine in the Family

    • Fitzhugh Mullan
    Ann Intern Med November 16, 2004 141:818-819

    Dad never complained in the least that I didn't go into psychiatry. Delighted as he was that I made it into medicine at all, he was supportive and endlessly interested in everything that I did. To him, the specialty didn't matter—public health, psychiatry, pediatrics—it was medicine that bonded us.

Letters

  • Helicobacter pylori and Idiopathic Thrombocytopenic Purpura

    • Giovanni Emilia,
    • Mario Luppi,
    • and Giuseppe Torelli
    Ann Intern Med November 16, 2004 141:820

  • Helicobacter pylori and Idiopathic Thrombocytopenic Purpura

    • Francesco Franceschi
    Ann Intern Med November 16, 2004 141:820

  • Improving Improvement

    • Paul Batalden
    Ann Intern Med November 16, 2004 141:820-821

  • Improving Improvement

    • Bruce D. Agins and
    • Clemens Steinbock
    Ann Intern Med November 16, 2004 141:821

  • Improving Improvement

    • Bruce E. Landon,
    • Paul D. Cleary,
    • and Ira B. Wilson
    Ann Intern Med November 16, 2004 141:821-822

  • Translating “Tight Control”?

    • Thomas E. Finucane
    Ann Intern Med November 16, 2004 141:822

  • Translating “Tight Control”?

    • Michael M. Engelgau,
    • Linda S. Geiss,
    • Dara Murphy,
    • K M. Venkat Narayan,
    • and Frank Vinicor
    Ann Intern Med November 16, 2004 141:822-823

  • Acute Hepatotoxicity Caused by Repaglinide

    • Daniel N. Nan,
    • José L. Hernández,
    • Marta Fernández-Ayala,
    • and Miguel Carrascosa
    Ann Intern Med November 16, 2004 141:823

Medical Writings: Book Notes

  • Handbook of Women's Health: An Evidence-Based Approach

    • Ellen Schur and
    • Joann Elmore
    Ann Intern Med November 16, 2004 141:824

  • Women's Health in Mid-Life: A Primary Care Guide

    • Ellen Schur and
    • Joann Elmore
    Ann Intern Med November 16, 2004 141:824

Current Clinical Issues

  • The Health Care Revival in Iraq

    • Jennifer Fisher Wilson
    Ann Intern Med November 16, 2004 141:825-828

Ad Libitum

Medical Notices

  • Medical Notices

    Ann Intern Med November 16, 2004 141:0

Summaries for Patients

  • What Is the Appropriate Level of Blood-Thinning Medication for Elderly People with Atrial Fibrillation?

    Ann Intern Med November 16, 2004 141:I-38

  • Detecting Pancreatic Cancer and Its Spread

    Ann Intern Med November 16, 2004 141:I-46

  • Glucocorticoid Medications and the Risk for Cardiovascular Disease

    Ann Intern Med November 16, 2004 141:I-58

  • The Use of Clinical Vignettes To Measure the Quality of Health Care

    Ann Intern Med November 16, 2004 141:I-67
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This Issue

November 16, 2004; 141 (10)
  1. Articles
  2. Improving Patient Care
  3. Updates
  4. Review
  5. Editorials
  6. On Being a Doctor
  7. Letters
  8. Medical Writings: Book Notes
  9. Current Clinical Issues
  10. Ad Libitum
  11. Medical Notices
  12. Summaries for Patients

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