Table of Contents

May 20, 2008; 148 (10)

Articles

  • The Role of Clinical Uncertainty in Treatment Decisions for Diabetic Patients with Uncontrolled Blood Pressure

    • Eve A. Kerr,
    • Brian J. Zikmund-Fisher,
    • Mandi L. Klamerus,
    • Usha Subramanian,
    • Mary M. Hogan,
    • and Timothy P. Hofer
    Ann Intern Med May 20, 2008 148:717-727

    Clinicians often fail to intensify antihypertensive therapy when their patient's blood pressure is elevated. Kerr and colleagues sought the reasons for this practice by studying 1169 diabetic patients with elevated triage blood pressure during routine primary care visits at 9 Veterans Affairs facilities. Half of the patients did not have an increase in antihypertensive drug dosage, which was associated with patient reports of taking their blood pressure at home, rechecking the blood pressure during the clinical visit, and discussing of antihypertensive medication. Uncertainty about the patient's true blood pressure may contribute to failure to intensify antihypertensive therapy.

  • Incidence of Types of Cancer among HIV-Infected Persons Compared with the General Population in the United States, 1992–2003

    • Pragna Patel,
    • Debra L. Hanson,
    • Patrick S. Sullivan,
    • Richard M. Novak,
    • Anne C. Moorman,
    • Tony C. Tong,
    • Scott D. Holmberg,
    • John T. Brooks,
    • and for the Adult and Adolescent Spectrum of Disease Project and HIV Outpatient Study Investigators
    Ann Intern Med May 20, 2008 148:728-736

    Antiretroviral therapy has dramatically improved survival of HIV-infected individuals and reduced the incidence of AIDS-defining cancer but may have—directly or indirectly—increased cases of non–AIDS-defining cancer. Patel and associates measured cancer incidence in HIV-infected persons and in the general population. The incidence of several types of non–AIDS-defining cancer was significantly higher in the HIV-infected population.

  • Association of Numeracy and Diabetes Control

    • Kerri Cavanaugh,
    • Mary Margaret Huizinga,
    • Kenneth A. Wallston,
    • Tebeb Gebretsadik,
    • Ayumi Shintani,
    • Dianne Davis,
    • Rebecca Pratt Gregory,
    • Lynn Fuchs,
    • Robb Malone,
    • Andrea Cherrington,
    • Michael Pignone,
    • Darren A. DeWalt,
    • Tom A. Elasy,
    • and Russell L. Rothman
    Ann Intern Med May 20, 2008 148:737-746

    We do not understand the influence of a patient's skill with numbers (also called numeracy) on their management of diabetes. Cavanaugh and colleagues tested the ability of 398 adult patients with type 1 or type 2 diabetes to perform tasks related to diabetes care that require calculations or interpretation of numerical results (diabetes-related numeracy). Poor numeracy skills were common, and low diabetes-related numeracy was associated with worse perceived self-efficacy, fewer diabetes self-management behaviors, and possibly poorer glycemic control.

Academia and Clinic

  • Using Existing Systematic Reviews in Complex Systematic Reviews

    • Evelyn P. Whitlock,
    • Jennifer S. Lin,
    • Roger Chou,
    • Paul Shekelle,
    • and Karen A. Robinson
    Ann Intern Med May 20, 2008 148:776-782

    Often the only way to answer a clinical question (for example, whether prostate cancer screening reduces cancer-related mortality) is to deconstruct the question into linked subquestions (for example, whether screening detects early cancer; whether early treatment affects mortality). Systematic reviews to support clinical practice guideline development or health policy decision making must often evaluate several linked clinical questions (complex reviews). To reduce the work required for a complex review, authors often use existing systematic reviews. Whitlock and colleagues discuss the methodological issues raised by incorporating existing systematic reviews into complex reviews.

Review

  • Systematic Review: The Effects of Growth Hormone on Athletic Performance

    • Hau Liu,
    • Dena M. Bravata,
    • Ingram Olkin,
    • Anne Friedlander,
    • Vincent Liu,
    • Brian Roberts,
    • Eran Bendavid,
    • Olga Saynina,
    • Shelley R. Salpeter,
    • Alan M. Garber,
    • and Andrew R. Hoffman
    Ann Intern Med May 20, 2008 148:747-758

    Athletes have reportedly used human growth hormone to improve performance, but its safety and performance-enhancing efficacy are poorly understood. Liu and colleagues reviewed 44 trials that compared growth hormone treatment with no growth hormone treatment in community-dwelling healthy participants age 13 to 45 years. Lean body mass increased more in growth hormone recipients than nonrecipients, but strength and exercise capacity did not improve. Growth hormone recipients were more likely to have soft tissue edema and fatigue. The authors conclude that the evidence does not support claims that growth hormone enhances physical performance.

Clinical Guidelines

  • Screening for Gestational Diabetes Mellitus: U.S. Preventive Services Task Force Recommendation Statement

    • U.S. Preventive Services Task Force
    Ann Intern Med May 20, 2008 148:759-765

    In this update of a 2003 recommendation, the U.S. Preventive Services Task Force concludes that the current evidence is insufficient to assess the balance of benefits and harms of routine screening for gestational diabetes mellitus, either before or after 24 weeks' gestation.

  • Screening for Gestational Diabetes Mellitus: A Systematic Review for the U.S. Preventive Services Task Force

    • Teresa A. Hillier,
    • Kimberly K. Vesco,
    • Kathryn L. Pedula,
    • Tracy L. Beil,
    • Evelyn P. Whitlock,
    • and David J. Pettitt
    Ann Intern Med May 20, 2008 148:766-775

    To support the updated U.S. Preventive Services Task Force recommendation in this issue, Hillier and colleagues reviewed the evidence on the benefits and harms of screening for gestational diabetes mellitus. They found no randomized, controlled trials that directly evaluated the risks and benefits, limited evidence suggesting that treatment after 24 weeks' gestation improves some maternal and neonatal outcomes, and very limited evidence about early screening before 24 weeks' gestation.

Editorials

  • It's Time to Overcome Clinical Inertia

    • Lawrence S. Phillips and
    • Jennifer G. Twombly
    Ann Intern Med May 20, 2008 148:783-785

    When blood pressure levels are above goal, clinicians often fail to intensify therapy—a practice called clinical inertia. Two recent Annals articles, one in this issue, provide information about the factors that contribute to clinical inertia in hypertension management. The studies suggest that clinical uncertainty about a patient's true blood pressure is a more important cause of clinical inertia than many comorbid conditions that require attention in a 15-minute visit. Clinicians will need a new paradigm to guide them in treating high blood pressure—it's time to overcome clinical inertia.

  • The Science and Art of Deduction: Complex Systematic Overviews

    • John E. Cornell and
    • Christine Laine
    Ann Intern Med May 20, 2008 148:786-788

    Annals has witnessed an increase in the frequency of “complex systematic overviews”—systematic reviews that use previous systematic reviews to construct an evidence base. Although using past systematic reviews can shorten the time required to produce an updated systematic review, complex systematic overviews present challenges. Cornell and Laine describe those challenges and provide suggestions for overcoming them.

  • An Advantageous Marriage

    • Harold C. Sox
    Ann Intern Med May 20, 2008 148:788

    This issue marks the marriage of 2 publications with large and loyal readerships—Annals of Internal Medicine and ACP Journal Club. Beginning today, ACP Journal Club will appear in the second of the 2 monthly issues of Annals.

Letters

  • Overviews and Systematic Reviews on Low Back Pain

    • Jan M. Bjordal,
    • Atle Klovning,
    • Rodrigo Alvaro B. Lopes-Martins,
    • Pål-Didrik Hoff Roland,
    • Jon Joensen,
    • and Lars Slørdal
    Ann Intern Med May 20, 2008 148:789-790

  • Overviews and Systematic Reviews on Low Back Pain

    • Edzard Ernst
    Ann Intern Med May 20, 2008 148:790-791

  • Overviews and Systematic Reviews on Low Back Pain

    • Roger Chou,
    • Paul Shekelle,
    • Amir Qaseem,
    • and Douglas K. Owens
    Ann Intern Med May 20, 2008 148:791-792

  • Prevalence and Incidence of Viral Infections among Musculoskeletal Tissue Donors and First-Time Blood Donors

    • Felix Yao,
    • Clive Seed,
    • David Wood,
    • and Ming-Hao Zheng
    Ann Intern Med May 20, 2008 148:792-794

  • Transfusion-Associated Babesiosis with an Atypical Time Course after Nonmyeloablative Transplantation for Sickle Cell Disease

    • Christopher M. Cirino,
    • Susan F. Leitman,
    • Esther Williams,
    • Daniel Fedorko,
    • Tara N. Palmore,
    • Amy Klion,
    • Christian Ockenhouse,
    • Courtney Fitzhugh,
    • John F. Tisdale,
    • and Matthew M. Hsieh
    Ann Intern Med May 20, 2008 148:794-795

  • Correction: Overanticoagulation with Coumarin and Cutaneous Azole Therapy

    Ann Intern Med May 20, 2008 148:795

Medical Writings: Book Notes

  • Treatment of the Obese Patient

    • Johanna T. Dwyer and
    • Jean Mayer
    Ann Intern Med May 20, 2008 148:796

  • Evaluating the Science and Ethics of Research on Humans: A Guide for IRB Members

    • Bernard M. Dickens
    Ann Intern Med May 20, 2008 148:796

Current Clinical Issues

  • Vermont Health Care Reform Aims for More Coverage, Less Expense, and Better Care

    • Jennifer Fisher Wilson
    Ann Intern Med May 20, 2008 148:797-800

Medical Notices

  • Medical Notices

    Ann Intern Med May 20, 2008 148:0

Summaries for Patients

  • Cancer in People with HIV Infection Compared with the General Population, 1992–2003

    Ann Intern Med May 20, 2008 148:I-46

  • Association of Numeracy and Diabetes Control

    Ann Intern Med May 20, 2008 148:I-53

  • Screening for Gestational Diabetes during Pregnancy: Recommendation from the U.S. Preventive Services Task Force

    Ann Intern Med May 20, 2008 148:I-60

ACP Journal Club

  • Editorial: ACP Journal Club: The Best New Evidence for Patient Care

    Ann Intern Med May 20, 2008 148:JC3-2

  • Review: Statins reduce all-cause mortality in elderly patients with coronary heart disease

    Ann Intern Med May 20, 2008 148:JC3-3

  • Testosterone supplementation did not prevent cognitive decline or increase bone mineral density in older men

    Ann Intern Med May 20, 2008 148:JC3-4

  • Review: Individual DMARDs have similar efficacy for rheumatoid arthritis, but combination therapy improves response

    Ann Intern Med May 20, 2008 148:JC3-5

  • Adjuvant chemotherapy increased survival in colorectal cancer patients with low recurrence risk

    Ann Intern Med May 20, 2008 148:JC3-6

  • Review: Evidence for the effectiveness of anticoagulation therapy or prophylaxis for VTE in cancer is limited

    Ann Intern Med May 20, 2008 148:JC3-7

  • Cetuximab improved overall survival in colorectal cancer patients in whom other treatments had failed

    Ann Intern Med May 20, 2008 148:JC3-8

  • Review: Fluid resuscitation with colloids does not reduce mortality more than crystalloids in critically ill patients

    Ann Intern Med May 20, 2008 148:JC3-9

  • Review: Primary prophylaxis with banding ligation or β-blockers does not differ for mortality in esophageal varices

    Ann Intern Med May 20, 2008 148:JC3-10

  • The combination of low midarm muscle circumference and high waist circumference predicted higher mortality in older men

    Ann Intern Med May 20, 2008 148:JC3-11

  • BMI and cardiorespiratory fitness predicted mortality in older adults

    Ann Intern Med May 20, 2008 148:JC3-12

  • Increasing BMI was associated with increasing risk for overall cancer incidence and mortality in middle-aged women

    Ann Intern Med May 20, 2008 148:JC3-13

  • Glomerular filtration rate < 45 mL/min/1.73 m2 with microalbuminuria was associated with increased risk for CV death

    Ann Intern Med May 20, 2008 148:JC3-14

  • Other Articles Noted

    Ann Intern Med May 20, 2008 148:JC3-15

  • Glossary

    Ann Intern Med May 20, 2008 148:JC3-16
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This Issue

May 20, 2008; 148 (10)
  1. Articles
  2. Academia and Clinic
  3. Review
  4. Clinical Guidelines
  5. Editorials
  6. Letters
  7. Medical Writings: Book Notes
  8. Current Clinical Issues
  9. Medical Notices
  10. Summaries for Patients
  11. ACP Journal Club

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