Table of Contents

April 19, 2005; 142 (8)

Articles

  • Clinical and Economic Implications of the Multicenter Automatic Defibrillator Implantation Trial-II

    • Sana M. Al-Khatib,
    • Kevin J. Anstrom,
    • Eric L. Eisenstein,
    • Eric D. Peterson,
    • James G. Jollis,
    • Daniel B. Mark,
    • Yun Li,
    • Christopher M. O'Connor,
    • Linda K. Shaw,
    • and Robert M. Califf
    Ann Intern Med April 19, 2005 142:593-600

    The Multicenter Automatic Defibrillator Implantation Trial (MADIT)-II showed that the implantable cardioverter defibrillator (ICD) prolongs life in patients with a history of myocardial infarction and an ejection fraction of 0.3 or less. Implanting defibrillators in everyone who meets these criteria will be expensive, but it is cost-effective because ICD therapy had such a large effect on survival in MADIT-II.

  • Cost-Effectiveness of Defending against Bioterrorism: A Comparison of Vaccination and Antibiotic Prophylaxis against Anthrax

    • Robert A. Fowler,
    • Gillian D. Sanders,
    • Dena M. Bravata,
    • Bahman Nouri,
    • Jason M. Gastwirth,
    • Dane Peterson,
    • Allison G. Broker,
    • Alan M. Garber,
    • and Douglas K. Owens
    Ann Intern Med April 19, 2005 142:601-610

    In the event of an aerosolized Bacillus anthracis bioweapon attack over an unvaccinated metropolitan U.S. population, postattack vaccination plus antibiotic therapy is the most effective and least expensive strategy.

  • The Effect of Metformin and Intensive Lifestyle Intervention on the Metabolic Syndrome: The Diabetes Prevention Program Randomized Trial

    • Trevor J. Orchard,
    • Marinella Temprosa,
    • Ronald Goldberg,
    • Steven Haffner,
    • Robert Ratner,
    • Santica Marcovina,
    • Sarah Fowler,
    • and for the Diabetes Prevention Program Research Group
    Ann Intern Med April 19, 2005 142:611-619

    At the beginning of the Diabetes Prevention Program, half of the participants had the metabolic syndrome. Both the lifestyle intervention and metformin therapy reduced the incidence of the syndrome in the remaining participants.

  • Brief Communication: High Incidence of Venous Thrombotic Events among Patients with Wegener Granulomatosis: The Wegener's Clinical Occurrence of Thrombosis (WeCLOT) Study

    • Peter A. Merkel,
    • Grace H. Lo,
    • Janet T. Holbrook,
    • Andrea K. Tibbs,
    • Nancy B. Allen,
    • John C. Davis, Jr,
    • Gary S. Hoffman,
    • W. Joseph McCune,
    • E. William St. Clair,
    • Ulrich Specks,
    • Robert Spiera,
    • Michelle Petri,
    • John H. Stone,
    • and for The Wegener's Granulomatosis Etanercept Trial Research Group*
    Ann Intern Med April 19, 2005 142:620-626

    The authors measured the rate of venous thromboembolism in a cohort of 180 patients with active Wegener granulomatosis. The annual rate is 7.0 per 100 persons in these patients. A population of healthy people of similar age had an annual rate of 0.31 per 100 persons. Active Wegener granulomatosis is a risk factor for venous thromboembolism.

Improving Patient Care

  • Ambiguity and Workarounds as Contributors to Medical Error

    • Steven J. Spear and
    • Mark Schmidhofer
    Ann Intern Med April 19, 2005 142:627-630

    We ask: Do medical errors have common root causes? Can we draw lessons to improve the reliability of health care by learning how other types of organizations reduced errors? When people in very high-performing organizations discover a problem, they don't find ways to work around it. They fix the problem so that it doesn't happen again.

Academia and Clinic

  • The Ethics of Deactivating Implanted Cardioverter Defibrillators

    • Jeffrey T. Berger
    Ann Intern Med April 19, 2005 142:631-634

    Implanting an automatic cardioverter defibrillator can lead to ethical dilemmas, but few researchers have studied these issues. We also don't have guidelines to assist physicians who care for patients who have received defibrillators. This paper discusses bioethical issues to consider in deciding whether to turn off an implantable cardioverter defibrillator.

Reviews

  • Meta-Analysis: Computed Tomographic Colonography

    • Brian P. Mulhall,
    • Ganesh R. Veerappan,
    • and Jeffrey L. Jackson
    Ann Intern Med April 19, 2005 142:635-650

    In more than 30 studies of computed tomographic (CT) colonography, the specificity of this test is consistently high, but the sensitivity varies over a wide range. This between-study variability raises concerns that must be resolved before CT colonography will be an acceptable screening test for colorectal cancer.

  • Meta-Analysis: Acupuncture for Low Back Pain

    • Eric Manheimer,
    • Adrian White,
    • Brian Berman,
    • Kelly Forys,
    • and Edzard Ernst
    Ann Intern Med April 19, 2005 142:651-663

    According to the evidence provided by 33 randomized trials, needle acupuncture provides better short-term relief for chronic low back pain than sham acupuncture or no treatment. The evidence about its effectiveness relative to other active treatments is inconclusive.

Editorials

  • Preventing Sudden Cardiac Death: Can We Afford the Benefit?

    • Stephen G. Pauker,
    • N. A. Mark Estes,
    • and Deeb N. Salem
    Ann Intern Med April 19, 2005 142:664-666

    Although implantable cardioverter defibrillators (ICDs) can prevent sudden cardiac death, the United States may not be able to afford the cost. Al-Khatib and colleagues' cost-effectiveness analysis supports using ICDs in patients similar to participants in the Multicenter Automatic Defibrillator Implantation Trial-II. However, we must continue to refine methods to select patients for ICDs in order to keep the costs in line with the benefits.

  • Being Prepared: Modeling the Response to an Anthrax Attack

    • Glenn F. Webb
    Ann Intern Med April 19, 2005 142:667-668

    In this issue, Fowler and colleagues' analysis strongly supports the current U.S. policy of vaccination and prophylactic antibiotics after an anthrax attack rather than preattack mass vaccination. At current estimates of the risk for an attack, mass vaccination of the entire U.S. population is unwarranted because adverse effects of the vaccine outweigh its benefits.

  • Can Computed Tomographic Colonography Become a “Good” Screening Test?

    • Thomas F. Imperiale
    Ann Intern Med April 19, 2005 142:669-670

    When prepless computed tomographic colonography achieves a reasonably high and consistent sensitivity for an appropriate target lesion, we may finally have a good screening test. At the current rate of progress, I expect the problems to be solved by the time I have to decide—as a patient—about colorectal cancer screening.

  • Primary Care, Generalism, Public Good: Déjà vu? Again!

    • Eric B. Larson,
    • Kenneth B. Roberts,
    • and Kevin Grumbach
    Ann Intern Med April 19, 2005 142:671-674

    We must convince people that primary care is a public good worth supporting. The ingredients of success include credible scientific evidence of effectiveness; impassioned, sustained advocacy; and a strong alliance with the public media, lawgivers, and regulators.

On Being a Doctor

  • Spot(s)

    • Bernard Robins
    Ann Intern Med April 19, 2005 142:675

    A physician reflects on a sick adolescent boy home alone and his own childhood pet. He wonders: “Was one of my motivations to heal born out of the memory of Spot?”

Letters

  • Warfarin or Not Warfarin?

    • Francisco J. Ruiz-Ruiz
    Ann Intern Med April 19, 2005 142:676

  • Warfarin or Not Warfarin?

    • Margaret C. Fang and
    • Daniel E. Singer
    Ann Intern Med April 19, 2005 142:676

  • Next-of-Kin Responses and Do-Not-Resuscitate Implications for Implantable Cardioverter Defibrillators

    • Laura J. Morrison and
    • Christian T. Sinclair
    Ann Intern Med April 19, 2005 142:676-677

  • Next-of-Kin Responses and Do-Not-Resuscitate Implications for Implantable Cardioverter Defibrillators

    • Nathan E. Goldstein,
    • Rachel Lampert,
    • and Harlan M. Krumholz
    Ann Intern Med April 19, 2005 142:677

  • Transient Left Ventricular Apical Ballooning

    • Borja Ibanez,
    • Jeronimo Farre,
    • and Felipe Navarro
    Ann Intern Med April 19, 2005 142:677-678

  • Transient Left Ventricular Apical Ballooning

    • R. Alizadeh Dehnavi and
    • E. E. van der Wall
    Ann Intern Med April 19, 2005 142:678

  • Transient Left Ventricular Apical Ballooning

    • Junya Ako,
    • Yasuhiro Honda,
    • and Peter J. Fitzgerald
    Ann Intern Med April 19, 2005 142:678

  • Transient Left Ventricular Apical Ballooning

    • Kevin A. Bybee and
    • Charanjit S. Rihal
    Ann Intern Med April 19, 2005 142:678-679

  • The New Mayo Clinic Equation for Estimating Glomerular Filtration Rate

    • Marc C. Froissart,
    • Jerome Rossert,
    • and Pascal Houillier
    Ann Intern Med April 19, 2005 142:679

  • The New Mayo Clinic Equation for Estimating Glomerular Filtration Rate

    • Pierre Delanaye and
    • Jean-Marie Krzesinski
    Ann Intern Med April 19, 2005 142:679-680

  • The New Mayo Clinic Equation for Estimating Glomerular Filtration Rate

    • Yoram Maaravi,
    • Michael Bursztyn,
    • and Jochanan Stessman
    Ann Intern Med April 19, 2005 142:680-681

  • The New Mayo Clinic Equation for Estimating Glomerular Filtration Rate

    • Andrew D. Rule and
    • Fernando G. Cosio
    Ann Intern Med April 19, 2005 142:681

  • Correction: Relative Importance of Borderline and Elevated Levels of Coronary Heart Disease Risk Factors

    Ann Intern Med April 19, 2005 142:681

Medical Writings: Book Notes

  • Antiviral Agents, Vaccines, and Immunotherapies

    • Upton D. Allen and
    • Chaim M. Roifman
    Ann Intern Med April 19, 2005 142:686

  • Cardiopulmonary Resuscitation

    • Roger D. White
    Ann Intern Med April 19, 2005 142:686

Medical Writings: Words That Make a Difference

  • On Saying Goodbye: Acknowledging the End of the Patient–Physician Relationship with Patients Who Are Near Death

    • Anthony L. Back,
    • Robert M. Arnold,
    • James A. Tulsky,
    • Walter F. Baile,
    • and Kelly A. Fryer-Edwards
    Ann Intern Med April 19, 2005 142:682-685

    The authors offer guidelines for saying goodbye to a dying patient. Saying goodbye is an expert practice worth learning for the sake of both the patient and the physician.

Medical Notices

  • Medical Notices

    Ann Intern Med April 19, 2005 142:0

Supplement: The Future of Generalism in Medicine

  • The Future of Generalism in Medicine

    • Eric B. Larson,
    • Kevin Grumbach,
    • and Kenneth B. Roberts
    Ann Intern Med April 19, 2005 142:689-690

  • The Essential Role of Generalists in Health Care Systems

    • Robert L. Ferrer,
    • Simon J. Hambidge,
    • and Rose C. Maly
    Ann Intern Med April 19, 2005 142:691-699

  • Coordinating Care across Diseases, Settings, and Clinicians: A Key Role for the Generalist in Practice

    • Christopher J. Stille,
    • Anthony Jerant,
    • Douglas Bell,
    • David Meltzer,
    • and Joann G. Elmore
    Ann Intern Med April 19, 2005 142:700-708

  • Processes for Effective Communication in Primary Care

    • Saul J. Weiner,
    • Beth Barnet,
    • Tina L. Cheng,
    • and Timothy P. Daaleman
    Ann Intern Med April 19, 2005 142:709-714

  • Rekindling Student Interest in Generalist Careers

    • Mark D. Schwartz,
    • William T. Basco, Jr,
    • Michael R. Grey,
    • Joann G. Elmore,
    • and Arthur Rubenstein
    Ann Intern Med April 19, 2005 142:715-724

Summaries for Patients

  • What Are the Clinical and Economic Implications of Following MADIT-II Criteria for Surgically Implanting Automatic Cardiac Defibrillators?

    Ann Intern Med April 19, 2005 142:I-39

  • What Is the Most Cost-Effective Way To Protect People in the Event of an Anthrax Terror Attack?

    Ann Intern Med April 19, 2005 142:I-40

  • The Effect of Diet and Exercise or Metformin on the Metabolic Syndrome

    Ann Intern Med April 19, 2005 142:I-46

  • Venous Thrombosis in Wegener Granulomatosis

    Ann Intern Med April 19, 2005 142:I-54

  • Accuracy of CT Colonography (Virtual Colonoscopy) for Detecting Polyps

    Ann Intern Med April 19, 2005 142:I-74

  • Acupuncture for the Treatment of Low Back Pain

    Ann Intern Med April 19, 2005 142:I-76
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This Issue

April 19, 2005; 142 (8)
  1. Articles
  2. Improving Patient Care
  3. Academia and Clinic
  4. Reviews
  5. Editorials
  6. On Being a Doctor
  7. Letters
  8. Medical Writings: Book Notes
  9. Medical Writings: Words That Make a Difference
  10. Medical Notices
  11. Supplement: The Future of Generalism in Medicine
  12. Summaries for Patients

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