Table of Contents

July 15, 2008; 149 (2)

Articles

  • Low-Molecular-Weight Heparin versus Compression Stockings for Thromboprophylaxis after Knee Arthroscopy: A Randomized Trial

    • Giuseppe Camporese,
    • Enrico Bernardi,
    • Paolo Prandoni,
    • Franco Noventa,
    • Fabio Verlato,
    • Paolo Simioni,
    • Kadimashi Ntita,
    • Giovanna Salmistraro,
    • Christos Frangos,
    • Franco Rossi,
    • Rosamaria Cordova,
    • Francesca Franz,
    • Pietro Zucchetta,
    • Dimitrios Kontothanassis,
    • Giuseppe Maria Andreozzi,
    • and for the KANT (Knee Arthroscopy Nadroparin Thromboprophylaxis) Study Group
    Ann Intern Med July 15, 2008 149:73-82

    In this trial, 1761 adults who had knee arthroscopy were randomly assigned to receive 7 or 14 days of low-molecular-weight heparin (LMWH) or to wear a full-length graduated compression stocking on the operated leg for 1 week. Fewer than 1% of the patients in any group had significant postsurgical bleeding complications. Fewer patients in the 7-day LMWH group experienced a composite outcome of deep venous thrombosis, pulmonary embolism, or death.

  • Empirical Fluconazole versus Placebo for Intensive Care Unit Patients: A Randomized Trial

    • Mindy G. Schuster,
    • John E. Edwards, Jr.,
    • Jack D. Sobel,
    • Rabih O. Darouiche,
    • Adolf W. Karchmer,
    • Susan Hadley,
    • Gus Slotman,
    • Helene Panzer,
    • Pinaki Biswas,
    • and John H. Rex
    Ann Intern Med July 15, 2008 149:83-90

    This multicenter trial tested the effect of empirical antifungal treatment in febrile intensive care unit patients. Investigators randomly assigned 270 patients with fever despite taking broad-spectrum antibiotics to either fluconazole, 800 mg/d, or placebo for 2 weeks. About 40% of patients in each group achieved all 4 components of successful treatment: resolution of fever, no invasive fungal infection, no stopping therapy because of toxicity, and no need for a nonstudy systemic antifungal medication. Compared with placebo, empirical antifungal fluconazole therapy had no effect in high-risk intensive care unit patients.

  • Prehypertension during Young Adulthood and Coronary Calcium Later in Life

    • Mark J. Pletcher,
    • Kirsten Bibbins-Domingo,
    • Cora E. Lewis,
    • Gina S. Wei,
    • Steve Sidney,
    • J. Jeffrey Carr,
    • Eric Vittinghoff,
    • Charles E. McCulloch,
    • and Stephen B. Hulley
    Ann Intern Med July 15, 2008 149:91-99

    In their prospective cohort study, Pletcher and colleagues found that prehypertension before age 35 years, especially systolic prehypertension, showed a graded association with coronary calcium later in life. This association remained strong after adjustment for differences in blood pressure elevation after age 35 years and other coronary risk factors and participant characteristics.

Improving Patient Care

  • Comparing Patient-Reported Hospital Adverse Events with Medical Record Review: Do Patients Know Something That Hospitals Do Not?

    • Joel S. Weissman,
    • Eric C. Schneider,
    • Saul N. Weingart,
    • Arnold M. Epstein,
    • JoAnn David-Kasdan,
    • Sandra Feibelmann,
    • Catherine L. Annas,
    • Nancy Ridley,
    • Leslie Kirle,
    • and Constantine Gatsonis
    Ann Intern Med July 15, 2008 149:100-108

    Little is known about whether patient interviews can reveal adverse events not detected by medical record review. Weissman and colleagues compared adverse event rates from postdischarge patient interviews with those from medical records. Among 998 study patients, 23% had at least 1 adverse event detected by interview, compared with 11% by record review. Record review identified 11 serious and preventable events. Interviews identified 21 serious and preventable events that were not documented in the medical record. Hospitals should consider adding questions about adverse events to postdischarge interviews.

Reviews

  • Meta-analysis: Combination Endoscopic and Drug Therapy to Prevent Variceal Rebleeding in Cirrhosis

    • Rosario Gonzalez,
    • Javier Zamora,
    • Judith Gomez-Camarero,
    • Luis-Miguel Molinero,
    • Rafael Bañares,
    • and Agustín Albillos
    Ann Intern Med July 15, 2008 149:109-122

    Gonzalez and coworkers performed a meta-analysis of 23 trials that compared the combination of endoscopic and β-blocker therapy with either therapy alone for preventing recurrent esophageal bleeding. Combination therapy was more effective. Most trials, however, studied variceal sclerotherapy, which has largely been superseded by variceal banding as the standard of care. To prevent variceal bleeding, combined endoscopic and oral β-blocker therapy seems to be more effective than either approach alone.

  • Initial Drug Resistance and Tuberculosis Treatment Outcomes: Systematic Review and Meta-analysis

    • Woojin Lew,
    • Madhukar Pai,
    • Olivia Oxlade,
    • Daniel Martin,
    • and Dick Menzies
    Ann Intern Med July 15, 2008 149:123-134

    Optimizing tuberculosis treatment outcomes is increasingly difficult as drug-resistant tuberculosis becomes more common. Lew and colleagues reviewed 22 trials and 7 cohort studies that involved 14 333 new tuberculosis cases. Poor outcomes were associated with drug-resistant organisms at the outset of therapy and with treatment that did not reflect drug-susceptibility testing. Failure or relapse rates were 35% to 40% for patients who received rifampin for 2 months and 20% for patients who received rifampin for 6 months. Settings that do not do susceptibility testing before tuberculosis treatment can expect poor outcomes.

History of Medicine

  • The First Use of Penicillin in the United States

    • Charles M. Grossman
    Ann Intern Med July 15, 2008 149:135-136

    The first dose of penicillin given in the United States was administered at Yale–New Haven Hospital on 12 March 1942 to a patient dying of septicemia. As a young Yale house officer, I found myself involved in what few of us then realized was a very profound sequence of events.

Editorials

  • Thromboprophylaxis in Knee Arthroscopy Patients: Revisiting Values and Preferences

    • Russell D. Hull
    Ann Intern Med July 15, 2008 149:137-139

    In this issue, Camporese and colleagues report the findings of a large randomized trial of LMWH prophylaxis in adults undergoing knee arthroscopy. The study adds substantive information on the efficacy and safety of LMWH prophylaxis for this indication, and the findings support using LMWH to prevent venous thromboembolism in knee arthroscopy patients undergoing meniscectomy.

  • The Answer Is In: Fluconazole Prophylaxis Is Not Beneficial for Intensive Care Unit Patients without Neutropenia

    • Thomas Fekete
    Ann Intern Med July 15, 2008 149:140-141

    In this issue, Schuster and colleagues show that empirical antifungal fluconazole therapy has no effect in high-risk intensive care unit patients with persistent fever despite taking conventional antibiotics. The time for empirical prophylactic studies of fluconazole in intensive care unit patients is over, and the authors encourage us to move on to other ways of improving patient outcomes.

On Being a Doctor

  • The Content of Their Character

    • Victor S. Sloan
    Ann Intern Med July 15, 2008 149:142-143

    Deep down, all of us have prejudices, and physicians are not immune. Almost 45 years after Dr. Martin Luther King Jr. wished that his children—and ours—would be judged by the content of their character rather than by the color of their skin, we still have a long way to go.

Letters

  • Drawing Conclusions about Short-Term Variability in Liver Function Test Results

    • Gaurav Arora and
    • George Triadafilopoulos
    Ann Intern Med July 15, 2008 149:144

  • Drawing Conclusions about Short-Term Variability in Liver Function Test Results

    • Weekitt Kittisupamongkol
    Ann Intern Med July 15, 2008 149:144

  • Drawing Conclusions about Short-Term Variability in Liver Function Test Results

    • Liu Hong,
    • Kaichun Wu,
    • and Daiming Fan
    Ann Intern Med July 15, 2008 149:144-145

  • Drawing Conclusions about Short-Term Variability in Liver Function Test Results

    • Agostino Colli and
    • Daniele Prati
    Ann Intern Med July 15, 2008 149:145

  • Drawing Conclusions about Short-Term Variability in Liver Function Test Results

    • Mariana Lazo,
    • Elizabeth Selvin,
    • and Jeanne M. Clark
    Ann Intern Med July 15, 2008 149:145-146

  • Not Sold on Performance Measures

    • Michael E. Miller
    Ann Intern Med July 15, 2008 149:146

  • Not Sold on Performance Measures

    • Bruce E. Landon and
    • Sharon-Lise T. Normand
    Ann Intern Med July 15, 2008 149:146-147

  • Correction: Screening for Type 2 Diabetes Mellitus in Adults

    Ann Intern Med July 15, 2008 149:147

  • Correction: A Leading Medical School Seriously Damaged

    Ann Intern Med July 15, 2008 149:147

Medical Writings: Book Notes

Current Clinical Issues

  • Oregon Surpasses Struggles of Early Reform and Develops a Road Map for Future Success

    • Jennifer Fisher Wilson
    Ann Intern Med July 15, 2008 149:149-152

Ad Libitum

Medical Notices

  • Medical Notices

    Ann Intern Med July 15, 2008 149:0

Summaries for Patients

ACP Journal Club

  • Editorial: Evidence-based medicine targets the individual patient. Part 2: Guides and tools for individual decision-making

    Ann Intern Med July 15, 2008 149:JC1-2

  • Adjustable gastric banding improved glycemic control in obese patients with type 2 diabetes

    Ann Intern Med July 15, 2008 149:JC1-3

  • A personal-contact weight-loss maintenance intervention reduced weight regain in overweight and obese adults

    Ann Intern Med July 15, 2008 149:JC1-4

  • Telling smokers their “lung age” promoted successful smoking cessation

    Ann Intern Med July 15, 2008 149:JC1-5

  • Review: Late percutaneous coronary intervention after AMI improves survival more than optimal medical therapy

    Ann Intern Med July 15, 2008 149:JC1-6

  • Review: Statins prevent stroke and reduce mortality

    Ann Intern Med July 15, 2008 149:JC1-7

  • Review: Low-molecular-weight heparin is better than unfractionated heparin to prevent VTE after ischemic stroke

    Ann Intern Med July 15, 2008 149:JC1-8

  • Review: Screening or case-finding questionnaires used alone are not effective in the management of depression

    Ann Intern Med July 15, 2008 149:JC1-9

  • Daily use of a lactobacilli probiotic prevented antibiotic-associated diarrhea in hospitalized patients

    Ann Intern Med July 15, 2008 149:JC1-10

  • Ventilation–perfusion scintigraphy provided useful information for diagnosing pulmonary embolism

    Ann Intern Med July 15, 2008 149:JC1-11

  • Review: Imaging techniques have similarly high accuracy for diagnosing cancer in solitary pulmonary nodules

    Ann Intern Med July 15, 2008 149:JC1-12

  • Age, sex, and functional impairment predicted risk for mortality in incident dementia at 14 years

    Ann Intern Med July 15, 2008 149:JC1-13

  • Young women's risk for first HPV infection was high and increased when the first male partner was sexually experienced

    Ann Intern Med July 15, 2008 149:JC1-14

  • Other Articles Noted

    Ann Intern Med July 15, 2008 149:JC1-15

  • Glossary

    Ann Intern Med July 15, 2008 149:JC1-16
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This Issue

July 15, 2008; 149 (2)
  1. Articles
  2. Improving Patient Care
  3. Reviews
  4. History of Medicine
  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
  13. ACP Journal Club

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