Table of Contents

August 15, 2006; 145 (4)

Articles

  • Cystatin C and Prognosis for Cardiovascular and Kidney Outcomes in Elderly Persons without Chronic Kidney Disease

    • Michael G. Shlipak,
    • Ronit Katz,
    • Mark J. Sarnak,
    • Linda F. Fried,
    • Anne B. Newman,
    • Catherine Stehman-Breen,
    • Stephen L. Seliger,
    • Brian Kestenbaum,
    • Bruce Psaty,
    • Russell P. Tracy,
    • and David S. Siscovick
    Ann Intern Med August 15, 2006 145:237-246

    In this longitudinal study involving 4663 elderly persons without known kidney disease (estimated glomerular filtration rate ≥ 60 mL/min per 1.73 m2), increasing cystatin C concentration was associated with increased risks for death, stroke, myocardial infarction, heart failure, and progression to chronic kidney disease. These associations were much stronger for cystatin C than for creatinine.

  • Using Standardized Serum Creatinine Values in the Modification of Diet in Renal Disease Study Equation for Estimating Glomerular Filtration Rate

    • Andrew S. Levey,
    • Josef Coresh,
    • Tom Greene,
    • Lesley A. Stevens,
    • Yaping (Lucy) Zhang,
    • Stephen Hendriksen,
    • John W. Kusek,
    • Frederick Van Lente,
    • and for the Chronic Kidney Disease Epidemiology Collaboration*
    Ann Intern Med August 15, 2006 145:247-254

    Using standardized creatinine assays, the authors remeasured serum creatinine levels in 1628 patients whose glomerular filtration rate (GFR) had been measured by urinary clearance of 125I-isothalamate. They used these data to derive new equations for estimating GFR from age, sex, ethnicity, and serum creatinine and then measured their accuracy. The equations were inaccurate only when kidney function was near-normal.

  • The Association between Common Vitamin D Receptor Gene Variations and Osteoporosis: A Participant-Level Meta-Analysis

    • André G. Uitterlinden,
    • Stuart H. Ralston,
    • Maria Luisa Brandi,
    • Alisoun H. Carey,
    • Daniel Grinberg,
    • Bente L. Langdahl,
    • Paul Lips,
    • Roman Lorenc,
    • Barbara Obermayer-Pietsch,
    • Jonathan Reeve,
    • David M. Reid,
    • Antonietta Amedei,
    • Amelia Bassiti,
    • Mariona Bustamante,
    • Lise Bjerre Husted,
    • Adolfo Diez-Perez,
    • Harald Dobnig,
    • Alison M. Dunning,
    • Anna Enjuanes,
    • Astrid Fahrleitner-Pammer,
    • Yue Fang,
    • Elzbieta Karczmarewicz,
    • Marcin Kruk,
    • Johannes P.T.M. van Leeuwen,
    • Carmelo Mavilia,
    • Joyce B.J. van Meurs,
    • Jon Mangion,
    • Fiona E.A. McGuigan,
    • Huibert A.P. Pols,
    • Wilfried Renner,
    • Fernando Rivadeneira,
    • Natasja M. van Schoor,
    • Serena Scollen,
    • Rachael E. Sherlock,
    • John P.A. Ioannidis,
    • APOSS Investigators,
    • EPOS Investigators,
    • EPOLOS Investigators,
    • FAMOS Investigators,
    • LASA Investigators,
    • Rotterdam Study Investigators,
    • and for the GENOMOS Study*
    Ann Intern Med August 15, 2006 145:255-264

    This multicenter, prospective study involving 26 242 participants examined associations between vitamin D receptor polymorphisms (Cdx2 promoter, FokI, BsmI, ApaI, and TaqI), bone mineral density (BMD), and fractures. These polymorphisms were not associated with BMD at the lumbar spine or femoral neck. Only the Cdx2 A-allele was associated with a small reduction in risk for vertebral fracture.

Improving Patient Care

  • Does Pay-for-Performance Improve the Quality of Health Care?

    • Laura A. Petersen,
    • LeChauncy D. Woodard,
    • Tracy Urech,
    • Christina Daw,
    • and Supicha Sookanan
    Ann Intern Med August 15, 2006 145:265-272

    This paper reviewed empirical studies that assessed the relationship between explicit financial incentives and the provision of high-quality health care. Thirteen of 17 studies examined the effect of incentives on process-of-care quality measures. Five of the 6 studies of physician-level financial incentives and 7 of the 9 studies of provider group–level financial incentives found partial or positive associations with measures of quality. One of the 2 studies of incentives at the payment-system level found a positive effect on access to care. In all, 4 studies suggested unintended effects of incentives.

  • Effects of Nurse Management on the Quality of Heart Failure Care in Minority Communities: A Randomized Trial

    • Jane E. Sisk,
    • Paul L. Hebert,
    • Carol R. Horowitz,
    • Mary Ann McLaughlin,
    • Jason J. Wang,
    • and Mark R. Chassin
    Ann Intern Med August 15, 2006 145:273-283

    This 12-month trial of assistance with managing systolic-dysfunction heart failure randomly assigned 406 ethnically diverse adults from Harlem, New York, to usual care or nurse management. Nurse management patients received counseling about sodium intake, fluid buildup, medication adherence, and self-management of symptoms. Nurses also regularly called patients and served as a bridge between patients and physicians. Compared with patients who received usual care, nurse management patients had fewer hospitalizations and better functioning.

Updates

  • Update in Gastroenterology and Hepatology

    • Norton J. Greenberger and
    • Prateek Sharma
    Ann Intern Med August 15, 2006 145:294-298

    This year's Update in Gastroenterology and Hepatology discusses Barrett esophagus, recurrent ulcer bleeding, colorectal cancer screening and prevention, traveler's diarrhea and Clostridium difficile–associated diarrhea, nonalcoholic fatty liver disease, smoking and chronic pancreatitis, and surgical treatment for obesity.

Review

  • Narrative Review: The Promotion of Gabapentin: An Analysis of Internal Industry Documents

    • Michael A. Steinman,
    • Lisa A. Bero,
    • Mary-Margaret Chren,
    • and C. Seth Landefeld
    Ann Intern Med August 15, 2006 145:284-293

    The authors used documents that became public through a court case to describe a manufacturer's methods to promote off-label uses of gabapentin. The manufacturer extensively used activities usually considered free of promotional intent, including continuing medical education and research, to promote gabapentin. Academic physicians played a large role in these activities. Academic medical centers must maintain a clearer separation between commercial activity and their mission of science and patient care.

Editorials

  • Decreased Kidney Function in the Elderly: Clinical and Preclinical, Neither Benign

    • Josef Coresh and
    • Brad Astor
    Ann Intern Med August 15, 2006 145:299-301

    In this issue, Shlipak and colleagues show that 2 markers of decreased kidney function, estimated glomerular filtration rate and cystatin C, are strong risk factors for noncardiovascular death as well as cardiovascular death and incidence. The most urgent next step is to evaluate these markers in combination with data on albuminuria.

  • Making Sense of Puzzling Genetic Association Studies: A Team Approach

    • Jennifer S. Lee and
    • Margaret A. Tucker
    Ann Intern Med August 15, 2006 145:302-304

    In the next quarter-century, the number of individuals affected by osteoporosis and related fractures will double. Understanding the pathogenesis of osteoporosis will require characterizing the interplay among multiple gene variants, gene products, environmental mediators, and bone. This is an essential step toward discovery of drugs that target the causative biological mechanism. In this issue, Uitterlinden and colleagues provide an excellent example that multicenter collaborative studies are crucial to efficiently and correctly identifying genes involved in osteoporosis and other complex diseases.

  • Safeguarding Patient Welfare: Who's In Charge?

    • Jane E. Henney
    Ann Intern Med August 15, 2006 145:305-307

    The article by Steinman and colleagues in this issue on the marketing of gabapentin guides the author's discussion of off-label uses of drugs, the changing regulatory power of the U.S. Food and Drug Administration, the role of industry, and the involvement of the medical profession in promoting off-label use, as well as clinicians' fundamental obligation to protect the best interests of their patients.

On Being a Doctor

  • The “Practice” of Medicine

    • Michael Papper
    Ann Intern Med August 15, 2006 145:308-309

    Anyone becoming a doctor will at some point be told by a reluctant patient, “You're not practicing on me,” or “I'm not having a medical student or a resident learning on me.” Usually, what ensues is a cowardly exodus of the trainee from the patient's room and a quick plea to the attending physician.

Letters

  • Pulmonary Embolism in Patients with Unexplained Exacerbations of Chronic Obstructive Pulmonary Disease

    • Grégoire Le Gal and
    • Marc Righini
    Ann Intern Med August 15, 2006 145:310

  • Pulmonary Embolism in Patients with Unexplained Exacerbations of Chronic Obstructive Pulmonary Disease

    • Isabelle Tillie-Leblond,
    • Charles-Hugo Marquette,
    • and Thierry Perez
    Ann Intern Med August 15, 2006 145:310

  • Lipohypertrophy in Acromegaly Induced by the New Growth Hormone Receptor Antagonist Pegvisomant

    • Pietro Maffei,
    • Chiara Martini,
    • Claudio Pagano,
    • Nicola Sicolo,
    • and Francesco Corbetti
    Ann Intern Med August 15, 2006 145:310-312

  • Correction: Book Notes: The Health Care Mess: How We Got Into It and What It Will Take To Get Out

    Ann Intern Med August 15, 2006 145:312

Current Clinical Issues

  • Health Insurance Portability and Accountability Act Privacy Rule Causes Ongoing Concerns among Clinicians and Researchers

    • Jennifer Fisher Wilson
    Ann Intern Med August 15, 2006 145:313-316

Ad Libitum

Medical Notices

  • Medical Notices

    Ann Intern Med August 15, 2006 145:0

Summaries for Patients

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This Issue

August 15, 2006; 145 (4)
  1. Articles
  2. Improving Patient Care
  3. Updates
  4. Review
  5. Editorials
  6. On Being a Doctor
  7. Letters
  8. Current Clinical Issues
  9. Ad Libitum
  10. Medical Notices
  11. Summaries for Patients

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