Table of Contents

September 2, 2008; 149 (5)

Articles

  • Risk for Opportunistic Disease and Death after Reinitiating Continuous Antiretroviral Therapy in Patients with HIV Previously Receiving Episodic Therapy: A Randomized Trial

    • The SMART Study Group
    Ann Intern Med September 2, 2008 149:289-299

    A previously published randomized, controlled trial showed that episodic use of antiretroviral therapy guided by CD4+ cell counts is inferior to continuous antiretroviral therapy. In a continuation of this trial, the SMART Study Group measured the effect of reinitiating continuous antiretroviral therapy on the excess risk for opportunistic disease or death due to episodic treatment. Resumption of continuous therapy rapidly suppressed HIV RNA and reduced—but did not eliminate—the excess risk for opportunistic disease or death.

  • Comparison of Patient- and Clinician-Collected Anal Cytology Samples to Screen for Human Papillomavirus–Associated Anal Intraepithelial Neoplasia in Men Who Have Sex with Men

    • Peter V. Chin-Hong,
    • J. Michael Berry,
    • Su-Chun Cheng,
    • Joseph A. Catania,
    • Maria Da Costa,
    • Teresa M. Darragh,
    • Fred Fishman,
    • Naomi Jay,
    • Lance M. Pollack,
    • and Joel M. Palefsky
    Ann Intern Med September 2, 2008 149:300-306

    Self-collected samples may increase adherence to anal cancer screening guidelines. This study compared the sensitivity and specificity of patient-collected and physician-collected cytology samples, using high-resolution anoscopy as the reference standard, in 126 men who have sex with men. Patient-collected specimens were feasible but unsatisfactory because many patients with anal intraepithelial neoplasia (AIN) had a negative cytology result after self-collection. Even with a physician-collected sample, anal cytology misses too many cases of AIN. Anoscopy is a better screening test, especially for high-risk patients.

  • Total and High-Molecular-Weight Adiponectin and Resistin in Relation to the Risk for Type 2 Diabetes in Women

    • Christin Heidemann,
    • Qi Sun,
    • Rob M. van Dam,
    • James B. Meigs,
    • Cuilin Zhang,
    • Shelley S. Tworoger,
    • Christos S. Mantzoros,
    • and Frank B. Hu
    Ann Intern Med September 2, 2008 149:307-316

    As biologically active molecules secreted by adipose tissue, adipokines might be the link between obesity and diabetes. The authors measured 2 adipokines (adiponectin and resistin) in 1038 initially healthy women of the Nurses' Health Study who later developed type 2 diabetes and 1136 matched control participants who did not develop diabetes. Adiponectin, but not resistin, was strongly associated with increased risk for diabetes, independent of body mass index.

  • Brief Communication: Physician Interest in Volunteer Service during Retirement

    • Philip D. Sloane,
    • Lauren W. Cohen,
    • Thomas R. Konrad,
    • Christianna S. Williams,
    • John G. Schumacher,
    • and Sheryl Zimmerman
    Ann Intern Med September 2, 2008 149:317-322

    Many “baby boomer” physicians are reaching retirement age, which is contributing to concerns about a physician shortage in the United States. If retired physicians volunteered to see patients, it would offset some of the effects of large-scale retirement. The authors surveyed 910 physicians 55 years of age or older living in North Carolina. At least one third expressed strong interest in volunteer teaching and working in free medical clinics during retirement. Programs that make it easy for retired physicians to be involved in patient care are needed.

Academia and Clinic

  • Burnout and Suicidal Ideation among U.S. Medical Students

    • Liselotte N. Dyrbye,
    • Matthew R. Thomas,
    • F. Stanford Massie,
    • David V Power,
    • Anne Eacker,
    • William Harper,
    • Steven Durning,
    • Christine Moutier,
    • Daniel W. Szydlo,
    • Paul J. Novotny,
    • Jeff A. Sloan,
    • and Tait D. Shanafelt
    Ann Intern Med September 2, 2008 149:334-341

    The stresses of medical school can lead to suicidal ideation or burnout. The prevalence of these conditions in medical students is not known. In a survey of 4287 medical students at 7 U.S. medical schools, 49.6% of students reported burnout and 11.2% reported suicidal ideation in the past year. Ninety-nine of the 370 students who met criteria for burnout subsequently recovered; recovery was associated with much lower rates of suicidal ideation.

Review

  • Systematic Review: The Trousseau Syndrome Revisited: Should We Screen Extensively for Cancer in Patients with Venous Thromboembolism?

    • Marc Carrier,
    • Grégoire Le Gal,
    • Philip S. Wells,
    • Dean Fergusson,
    • Tim Ramsay,
    • and Marc A. Rodger
    Ann Intern Med September 2, 2008 149:323-333

    In a systematic review, Carrier and colleagues summarized 36 studies of the prevalence of previously undiagnosed cancer at diagnosis and various time points after unprovoked venous thromboembolism (VTE). They also measured the number of cases detected by limited and extensive occult cancer screening at the time of VTE diagnosis. The prevalence of occult cancer was 6.1% at VTE diagnosis and increased to 10.0% 12 months after VTE diagnosis. Extensive screening increased the proportion of cases that were detected at baseline (from 49.4% to 69.7% with limited screening) but still missed many cases.

Medicine and Public Issues

  • Whistleblower-Initiated Enforcement Actions against Health Care Fraud and Abuse in the United States, 1996 to 2005

    • Aaron S. Kesselheim and
    • David M. Studdert
    Ann Intern Med September 2, 2008 149:342-349

    The Department of Justice has increased its efforts to prosecute health care fraud litigation. Whistleblowers play a major role in calling attention to health care fraud and receive 15% to 25% of the money recovered from defendants. Among 370 cases of federal health care fraud litigation from 1996 to 2005, the government recovered $9.3 billion from defendants, of which whistleblowers received more than $1.0 billion. Whistleblowers were often executives or physicians, and 75% were employees of defendant organizations.

Editorial

  • A Nickel's Worth of Cancer

    • Deborah L. Ornstein
    Ann Intern Med September 2, 2008 149:350-352

    In this issue, Carrier and colleagues report the period prevalence of cancer in patients with VTE at 3 time points and confirm that unprovoked VTE is more commonly associated with cancer than provoked VTE, and that extensive screening finds more cases of cancer at baseline than usual care. These findings demonstrate that if we look hard enough, we can find hidden cancer in a sizeable proportion of patients with idiopathic VTE. However, the search for cancer is expensive, and we do not know whether finding it changes survival.

On Being a Doctor

  • Internship in Africa: Death and Life

    • Elisabeth D. Riviello
    Ann Intern Med September 2, 2008 149:353-354

On Being a Patient

Letters

  • Are Short-Term or Long-Term Recurrence Rates More Important in Breast Cancer Screening?

    • Emiel J.T. Rutgers,
    • Lajos Pusztai,
    • and René Bernards
    Ann Intern Med September 2, 2008 149:357

  • Are Short-Term or Long-Term Recurrence Rates More Important in Breast Cancer Screening?

    • Steven N. Goodman,
    • Luigi Marchionni,
    • and Antonio C. Wolff
    Ann Intern Med September 2, 2008 149:357-358

  • The Importance of Measuring Executive Function When Studying the Effects of Cognition-Enhancing Agents

    • Kenneth Rockwood
    Ann Intern Med September 2, 2008 149:358-359

  • The Importance of Measuring Executive Function When Studying the Effects of Cognition-Enhancing Agents

    • Parminder Raina,
    • Pasqualina L. Santaguida,
    • and Christopher Patterson
    Ann Intern Med September 2, 2008 149:359-360

  • Should We Shorten or Lengthen Postpolypectomy Surveillance Intervals?

    • Douglas K. Rex and
    • Sidney J. Winawer
    Ann Intern Med September 2, 2008 149:360

  • Should We Shorten or Lengthen Postpolypectomy Surveillance Intervals?

    • Adeyinka O. Laiyemo,
    • Elaine Lanza,
    • and Arthur Schatzkin
    Ann Intern Med September 2, 2008 149:360-361

  • Effect of Testosterone Therapy versus Other Factors on the Self-reported Sexual Satisfaction of Premenopausal Women

    • Liu Hong,
    • Kaichun Wu,
    • and Daiming Fan
    Ann Intern Med September 2, 2008 149:361

  • Effect of Testosterone Therapy versus Other Factors on the Self-reported Sexual Satisfaction of Premenopausal Women

    • Hari Kumar,
    • Jayaraman Muthukrishnan,
    • and Kirtikumar D. Modi
    Ann Intern Med September 2, 2008 149:361

  • Effect of Testosterone Therapy versus Other Factors on the Self-reported Sexual Satisfaction of Premenopausal Women

    • Susan R. Davis,
    • Bronwyn G.A. Stuckey,
    • John Wlodarczyk,
    • Andrew Humberstone,
    • and Robert J. Norman
    Ann Intern Med September 2, 2008 149:361-362

  • Treatment Intensification Does Not Always Lead to Better Quality of Care in Patients with Hypertension

    • Jose M. Valderas
    Ann Intern Med September 2, 2008 149:362

  • Treatment Intensification Does Not Always Lead to Better Quality of Care in Patients with Hypertension

    • Barbara J. Turner,
    • David St. Michel,
    • and Simon Tang
    Ann Intern Med September 2, 2008 149:362-363

  • Lack of Nationwide Surveillance of Antimicrobial Resistance of Neisseria gonorrhoeae in Japan

    • Takashi Deguchi,
    • Mitsuru Yasuda,
    • and Shin-ichi Maeda
    Ann Intern Med September 2, 2008 149:363-364

  • Who Owns Vermont's Hospitals?

    • Megan E. Castonguay
    Ann Intern Med September 2, 2008 149:364

  • Exogenous Lipoid Pneumonia: An Unexpected Complication of Substance Abuse

    • Michael N. Gurell,
    • R. Matthew Kottmann,
    • Haodong Xu,
    • and Patricia J. Sime
    Ann Intern Med September 2, 2008 149:364-365

  • Use of Levosimendan for Cardiogenic Shock in a Patient with the Apical Ballooning Syndrome

    • Vincenzo De Santis,
    • Domenico Vitale,
    • Luigi Tritapepe,
    • Cesare Greco,
    • and Paolo Pietropaoli
    Ann Intern Med September 2, 2008 149:365-367

Medical Writings: Book Notes

  • Fenway Guide to Lesbian, Gay, Bisexual and Transgender Health

    • Michael A. Horberg
    Ann Intern Med September 2, 2008 149:368

  • Medical Care of the Pregnant Patient

    • Robert L. Barbieri
    Ann Intern Med September 2, 2008 149:368

Ad Libitum

Medical Notices

  • Medical Notices

    Ann Intern Med September 2, 2008 149:0

Summaries for Patients

  • Outcomes of HIV Infection in Persons Who Resume Treatment after Interruptions

    Ann Intern Med September 2, 2008 149:I-30

  • Comparison of Patient- and Physician-Collected Specimens to Screen for Anal Cancer

    Ann Intern Med September 2, 2008 149:I-38

In the Clinic

  • Deep Venous Thrombosis

    Ann Intern Med September 2, 2008 149:ITC3-1

    This issue provides a clinical overview of deep venous thrombosis, focusing on prevention, diagnosis, treatment, practice improvement, and patient information. Readers can complete the accompanying CME quiz for 1.5 credits.

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This Issue

September 2, 2008; 149 (5)
  1. Articles
  2. Academia and Clinic
  3. Review
  4. Medicine and Public Issues
  5. Editorial
  6. On Being a Doctor
  7. On Being a Patient
  8. Letters
  9. Medical Writings: Book Notes
  10. Ad Libitum
  11. Medical Notices
  12. Summaries for Patients
  13. In the Clinic

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