Table of Contents

November 18, 2008; 149 (10)

Articles

  • Adverse Events with 4 Months of Rifampin Therapy or 9 Months of Isoniazid Therapy for Latent Tuberculosis Infection: A Randomized Trial

    • Dick Menzies,
    • Richard Long,
    • Anete Trajman,
    • Marie-Josée Dion,
    • Jae Yang,
    • Hamdan Al Jahdali,
    • Ziad Memish,
    • Kamran Khan,
    • Michael Gardam,
    • Vernon Hoeppner,
    • Andrea Benedetti,
    • and Kevin Schwartzman
    Ann Intern Med November 18, 2008 149:689-697

    Nine-month isoniazid treatment of latent tuberculosis infection is hepatotoxic and is complicated by poor patient adherence. Menzies and colleagues compared the frequency of adverse events and treatment completion between 4-month rifampin therapy and 9-month isoniazid therapy among 847 patients randomly assigned to either treatment. Patients who took rifampin had fewer adverse events and were more likely to complete treatment. The investigators did not compare efficacy of the 2 treatments, so their data justify a larger trial to compare the efficacy of these 2 treatments for latent tuberculosis infection.

  • Determinants and Time Course of the Postthrombotic Syndrome after Acute Deep Venous Thrombosis

    • Susan R. Kahn,
    • Ian Shrier,
    • Jim A. Julian,
    • Thierry Ducruet,
    • Louise Arsenault,
    • Marie-José Miron,
    • Andre Roussin,
    • Sylvie Desmarais,
    • France Joyal,
    • Jeannine Kassis,
    • Susan Solymoss,
    • Louis Desjardins,
    • Donna L. Lamping,
    • Mira Johri,
    • and Jeffrey S. Ginsberg
    Ann Intern Med November 18, 2008 149:698-707

    Chronic leg symptoms after deep venous thrombosis (DVT) (the postthrombotic syndrome) are common but difficult to predict. By using a standardized scale, Kahn and coworkers evaluated leg symptoms in 387 patients for 2 years after DVT. Mild, moderate, and severe postthrombotic syndrome occurred in 30%, 10%, and 3% of patients, respectively, at all study intervals, but severity fluctuated over time in many patients. Age, previous DVT, and severity at 1 month were the best predictors of long-term severity.

  • Motivational Enhancement Therapy with and without Cognitive Behavior Therapy to Treat Type 1 Diabetes: A Randomized Trial

    • Khalida Ismail,
    • Stephen M. Thomas,
    • Esther Maissi,
    • Trudie Chalder,
    • Ulrike Schmidt,
    • Jonathan Bartlett,
    • Anita Patel,
    • Christopher M. Dickens,
    • Francis Creed,
    • and Janet Treasure
    Ann Intern Med November 18, 2008 149:708-719

    Psychological issues can interfere with management of type 1 diabetes. Ismail and colleagues examined whether psychological therapy might improve diabetes control. They compared motivational enhancement therapy with and without cognitive behavior therapy with usual care in 344 adults with type 1 diabetes (average baseline hemoglobin A1c level, 9.4%). Motivational enhancement therapy plus cognitive behavior therapy achieved a greater decrease in hemoglobin A1c over 12 months than did usual care (difference between groups, −0.46%). No other improvements were observed.

Improving Patient Care

  • Healing Skills for Medical Practice

    • Larry R. Churchill and
    • David Schenck
    Ann Intern Med November 18, 2008 149:720-724

    Physicians' relationships with their patients can have healing effects, but the skills required are understudied. Churchill and Schenck interviewed 50 allopathic and alternative medicine practitioners identified by peers. Eight skills emerged as pivotal: do the little things; take time; be open and listen; find something to like, to love; remove barriers; let the patient explain; share authority; and be committed.

Academia and Clinic

  • Assessing the Value of Risk Predictions by Using Risk Stratification Tables

    • Holly Janes,
    • Margaret S. Pepe,
    • and Wen Gu
    Ann Intern Med November 18, 2008 149:751-760

    Risk stratification tables evaluate the benefit of adding a new risk marker to a risk prediction model that includes an established set of markers. Janes and colleagues show how to use the tables to compare models with and without the new marker for 3 important measures of model performance. They discuss how the tables are an improvement over commonly reported measures of risk prediction model performance.

Clinical Guidelines

  • Using Second-Generation Antidepressants to Treat Depressive Disorders: A Clinical Practice Guideline from the American College of Physicians

    • Amir Qaseem,
    • Vincenza Snow,
    • Thomas D. Denberg,
    • Mary Ann Forciea,
    • Douglas K. Owens,
    • and for the Clinical Efficacy Assessment Subcommittee of the American College of Physicians
    Ann Intern Med November 18, 2008 149:725-733

    This guideline presents current evidence on second-generation antidepressant treatment during the acute, continuation, and maintenance phases of major depressive disorder, dysthymia, subsyndromal depression, and accompanying symptoms. The American College of Physicians recommends that clinicians select second-generation antidepressants on the basis of adverse effect profiles, cost, and patient preferences. Clinicians should assess patient status, therapeutic response, and adverse effects of therapy on a regular basis beginning within 1 to 2 weeks of therapy initiation and should modify treatment if no adequate response to therapy is observed within 6 to 8 weeks of the therapy initiation. Treatment should continue for 4 to 9 months after a satisfactory response in patients with a first episode or for even longer in patients who have had 2 or more episodes.

  • Comparative Benefits and Harms of Second-Generation Antidepressants: Background Paper for the American College of Physicians

    • Gerald Gartlehner,
    • Bradley N. Gaynes,
    • Richard A. Hansen,
    • Patricia Thieda,
    • Angela DeVeaugh-Geiss,
    • Erin E. Krebs,
    • Charity G. Moore,
    • Laura Morgan,
    • and Kathleen N. Lohr
    Ann Intern Med November 18, 2008 149:734-750

    The authors reviewed the evidence of the benefits and harms of second-generation antidepressants for the treatment of depressive disorders in adults. They found that second-generation antidepressants did not substantially differ in efficacy or effectiveness (on the basis of 203 studies), but the incidence of specific adverse events and the onset of action did differ. The evidence is insufficient to draw conclusions about the comparative efficacy, effectiveness, or harms of these agents for the treatment of dysthymia and subsyndromal depression.

Editorial

  • Needed: New and Better Tools to Combat Latent Tuberculosis Infection

    • Henry M. Blumberg
    Ann Intern Med November 18, 2008 149:761-763

    Poor acceptance and adherence to treatment regimens for latent tuberculosis infection (LTBI) are common. In this issue, Menzies and colleagues found that grade 3 to 4 hepatotoxicity was significantly less common among patients randomly assigned to 4 months of rifampin therapy than among those randomly assigned to 9 months of isoniazid therapy. Patients in the rifampin group were also more likely to complete treatment. The authors rightly conclude that a large-scale trial is indicated to assess the efficacy of rifampin monotherapy for the treatment of LTBI.

On Being a Doctor

  • Death and Hope in the ICU

    • David B. Seder
    Ann Intern Med November 18, 2008 149:764-765

    Sitting down, looking strangers in the eye, and talking about death is part of the poetry of critical care. At first I thought that I had a talent for these discussions—that they were something others avoided that I could do. But that isn't quite right. In fact, these are opportunities for performance, and I seek them out like strong coffee or difficult procedures.

  • Twilight

    • Andrea A. Peterson
    Ann Intern Med November 18, 2008 149:766

    When I sit down on the side of the bed, I know. He has pale blue eyes and a careworn face, and I know that I will not make it home for dinner. I speak slowly and say, “On the CT scan, there are multiple abnormal spots in your liver.” A pause, then: “It looks like the cancer has spread.”

Letters

  • What Conclusions Should Be Drawn between Critical Care Physician Management and Patient Mortality in the Intensive Care Unit?

    • Thomas L. Higgins,
    • Brian Nathanson,
    • and Daniel Teres
    Ann Intern Med November 18, 2008 149:767

  • What Conclusions Should Be Drawn between Critical Care Physician Management and Patient Mortality in the Intensive Care Unit?

    • Andrew A. Quartin,
    • Roland M.H. Schein,
    • and Cynthia M. Cely
    Ann Intern Med November 18, 2008 149:767-768

  • What Conclusions Should Be Drawn between Critical Care Physician Management and Patient Mortality in the Intensive Care Unit?

    • Michael Blumhardt
    Ann Intern Med November 18, 2008 149:768

  • What Conclusions Should Be Drawn between Critical Care Physician Management and Patient Mortality in the Intensive Care Unit?

    • Joris J. Arends and
    • Jan P. Vandenbroucke
    Ann Intern Med November 18, 2008 149:768-769

  • What Conclusions Should Be Drawn between Critical Care Physician Management and Patient Mortality in the Intensive Care Unit?

    • Tihomir Stefanec
    Ann Intern Med November 18, 2008 149:769

  • What Conclusions Should Be Drawn between Critical Care Physician Management and Patient Mortality in the Intensive Care Unit?

    • William T. McGee
    Ann Intern Med November 18, 2008 149:769-770

  • What Conclusions Should Be Drawn between Critical Care Physician Management and Patient Mortality in the Intensive Care Unit?

    • Constantine Manthous and
    • Yaw Amoateng-Adjepong
    Ann Intern Med November 18, 2008 149:770

  • What Conclusions Should Be Drawn between Critical Care Physician Management and Patient Mortality in the Intensive Care Unit?

    • Paul Marik,
    • John Myburgh,
    • Djillali Annane,
    • Jean-Louis Vincent,
    • Stephen Pastores,
    • G. Umberto Meduri,
    • and Albertus Beishuizen
    Ann Intern Med November 18, 2008 149:770-771

  • What Conclusions Should Be Drawn between Critical Care Physician Management and Patient Mortality in the Intensive Care Unit?

    • Marya D. Zilberberg and
    • Andrew F. Shorr
    Ann Intern Med November 18, 2008 149:771-772

  • What Conclusions Should Be Drawn between Critical Care Physician Management and Patient Mortality in the Intensive Care Unit?

    • Mitchell M. Levy,
    • John Rapoport,
    • Stan Lemeshow,
    • Gary Phillips,
    • Donald B. Chalfin,
    • and Marion Danis
    Ann Intern Med November 18, 2008 149:772

  • ADVANTAGE: Science First, Marketing Second

    • Jonathan M. Edelman
    Ann Intern Med November 18, 2008 149:773

  • ADVANTAGE: Science First, Marketing Second

    • Kevin P. Hill,
    • David S. Egilman,
    • and Harlan M. Krumholz
    Ann Intern Med November 18, 2008 149:773-774

  • ADVANTAGE: Merck Does Say “No”

    • Alexander Rabin
    Ann Intern Med November 18, 2008 149:774

  • ADVANTAGE: Merck Does Say “No”

    • Jonathan M. Edelman
    Ann Intern Med November 18, 2008 149:774-775

  • ADVANTAGE: Merck Does Say “No”

    • Harold C. Sox and
    • Drummond Rennie
    Ann Intern Med November 18, 2008 149:775

  • The Vanderbilt Method for Resolving Unprofessional Behavior

    • Denise M. Dupras and
    • Randall S. Edson
    Ann Intern Med November 18, 2008 149:775-776

Ad Libitum

Medical Notices

  • Medical Notices

    Ann Intern Med November 18, 2008 149:0

Summaries for Patients

ACP Journal Club

  • Editorial: Evidence in context: One person's poison is another's acceptable risk

    Ann Intern Med November 18, 2008 149:JC5-2

  • Review: Hemoglobin-based blood substitutes increase mortality and myocardial infarction in surgical, trauma, and stroke settings

    Ann Intern Med November 18, 2008 149:JC5-4

  • Review: Anticoagulation with INRs < 2 or between 3 and 5 increases risk for thromboembolic or hemorrhagic events

    Ann Intern Med November 18, 2008 149:JC5-5

  • Intensive and less-intensive renal replacement therapy did not differ for death or kidney function in critically ill patients

    Ann Intern Med November 18, 2008 149:JC5-6

  • Review: An early invasive strategy has similar benefits in men and women with NSTEMI or unstable angina

    Ann Intern Med November 18, 2008 149:JC5-7

  • Tibolone reduced risk for fractures and breast cancer but increased risk for stroke in older women with osteoporosis

    Ann Intern Med November 18, 2008 149:JC5-8

  • 4% lidocaine gel applied to the breasts before screening mammography reduced discomfort

    Ann Intern Med November 18, 2008 149:JC5-9

  • Review: Endoscopic plus drug therapy prevents rebleeding more than either one alone in cirrhosis with bleeding esophageal varices

    Ann Intern Med November 18, 2008 149:JC5-10

  • Review: Rifaximin is equally or more effective than other antibiotics and lactulose for hepatic encephalopathy

    Ann Intern Med November 18, 2008 149:JC5-11

  • Eradication of H. pylori after endoscopic resection for early gastric cancer reduced risk for metachronous gastric cancer

    Ann Intern Med November 18, 2008 149:JC5-12

  • Review: Psychological interventions prevent depression after stroke

    Ann Intern Med November 18, 2008 149:JC5-13

  • 10-year risk for CV events was 10% to 56% in rheumatoid arthritis; risk was greatest for patients with CV risk factors

    Ann Intern Med November 18, 2008 149:JC5-14

  • Excess mortality after HIV seroconversion has greatly decreased in the past 10 years

    Ann Intern Med November 18, 2008 149:JC5-15

  • Glossary

    Ann Intern Med November 18, 2008 149:JC5-16
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This Issue

November 18, 2008; 149 (10)
  1. Articles
  2. Improving Patient Care
  3. Academia and Clinic
  4. Clinical Guidelines
  5. Editorial
  6. On Being a Doctor
  7. Letters
  8. Ad Libitum
  9. Medical Notices
  10. Summaries for Patients
  11. ACP Journal Club

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