Table of Contents

May 19, 2009; 150 (10)

Articles

  • Splint for Base-of-Thumb Osteoarthritis: A Randomized Trial

    • François Rannou,
    • Jérôme Dimet,
    • Isabelle Boutron,
    • Gabriel Baron,
    • Fouad Fayad,
    • Yann Macé,
    • Johann Beaudreuil,
    • Pascal Richette,
    • Philippe Ravaud,
    • Michel Revel,
    • and Serge Poiraudeau
    Ann Intern Med May 19, 2009 150:661-669; doi:10.1059/0003-4819-150-10-200905190-00003

    Base-of-thumb osteoarthritis causes pain and disability and is common in middle-age and elderly adults. Rannou and colleagues assessed the efficacy and safety of a splint for base-of-thumb osteoarthritis. They randomly assigned 112 patients to wear a custom-made splint at night or to usual care. Nighttime splinting had no effect after 1 month, but it significantly reduced pain and disability after 12 months.

  • Pulse Versus Daily Oral Cyclophosphamide for Induction of Remission in Antineutrophil Cytoplasmic Antibody—Associated Vasculitis: A Randomized Trial

    • Kirsten de Groot,
    • Lorraine Harper,
    • David R.W. Jayne,
    • Luis Felipe Flores Suarez,
    • Gina Gregorini,
    • Wolfgang L. Gross,
    • Rashid Luqmani,
    • Charles D. Pusey,
    • Niels Rasmussen,
    • Renato A. Sinico,
    • Vladimir Tesar,
    • Philippe Vanhille,
    • Kerstin Westman,
    • Caroline O.S. Savage,
    • and for the EUVAS (European Vasculitis Study Group)
    Ann Intern Med May 19, 2009 150:670-680; doi:10.1059/0003-4819-150-10-200905190-00004

    Toxicity limits the use of cyclophosphamide for anti-neutrophil cytoplasmic antibody (ANCA)–associated vasculitis. In this comparison of pulse versus daily oral cyclophosphamide regimens, equal proportions of patients had remissions, but the pulse regimen seemed safer, mainly because of fewer cases of leukopenia. However, patients and providers were not blinded, and the study did not measure differences in relapse rate. Pulse and daily oral cyclophosphamide treatment seem to be equally efficacious for ANCA–associated vasculitis, but pulse therapy may be safer.

  • Hyperkyphosis Predicts Mortality Independent of Vertebral Osteoporosis in Older Women

    • Deborah M. Kado,
    • Li-Yung Lui,
    • Kristine E. Ensrud,
    • Howard A. Fink,
    • Arun S. Karlamangla,
    • Steven R. Cummings,
    • and for the Study of Osteoporotic Fractures
    Ann Intern Med May 19, 2009 150:681-687; doi:10.1059/0003-4819-150-10-200905190-00005

    In a 4-center cohort study of older white women, kyphosis with a history of previous vertebral fractures predicted an earlier death. The increased risk seemed independent of several factors, including age and underlying spinal osteoporosis. Kyphosis without vertebral fractures did not incur an increased risk for death. Women with vertebral fractures and hyperkyphosis are at greater risk for early death than women with only 1 of these conditions.

  • The President's Emergency Plan for AIDS Relief in Africa: An Evaluation of Outcomes

    • Eran Bendavid and
    • Jayanta Bhattacharya
    Ann Intern Med May 19, 2009 150:688-695; doi:10.1059/0003-4819-150-10-200905190-00117

    Since 2003, the President's Emergency Plan for AIDS Relief (PEPFAR) has provided financial assistance to 15 countries for HIV and AIDS prevention, treatment, and care. Bendavid and Bhattacharya used data obtained from the United Nations to assess PEPFAR's effect on HIV outcomes and prevalence in 12 sub-Saharan African countries receiving assistance. The number of HIV-related deaths decreased after PEPFAR began, but the prevalence of HIV in adults did not change.

Improving Patient Care

  • Shop for Quality or Volume? Volume, Quality, and Outcomes of Coronary Artery Bypass Surgery

    • Andrew D. Auerbach,
    • Joan F. Hilton,
    • Judith Maselli,
    • Penelope S. Pekow,
    • Michael B. Rothberg,
    • and Peter K. Lindenauer
    Ann Intern Med May 19, 2009 150:696-704; doi:10.1059/0003-4819-150-10-200905190-00007

    The authors sought to measure the contribution of better quality of care to better outcomes of coronary artery bypass surgery in hospitals that do a larger volume of surgery. The highest surgeon volume and highest hospital volume were associated with lower 30-day mortality rates and lower readmission risk, respectively. Adjustment for individual quality measures did not change these associations. However, if no quality measures were missed, mortality rates at the lowest-volume centers and highest-volume centers were similar. High overall quality seems to be more important than volume.

Academia and Clinic

  • Current Guidelines for Using Angiotensin-Converting Enzyme Inhibitors and Angiotensin II–Receptor Antagonists in Chronic Kidney Disease: Is the Evidence Base Relevant to Older Adults?

    • Ann M. O'Hare,
    • James S. Kaufman,
    • Kenneth E. Covinsky,
    • C. Seth Landefeld,
    • Lynne V. McFarland,
    • and Eric B. Larson
    Ann Intern Med May 19, 2009 150:717-724; doi:10.1059/0003-4819-150-10-200905190-00010

    Practice guidelines recommend angiotensin-converting enzyme inhibitors and angiotensin II–receptor antagonists for chronic kidney disease. The authors asked whether the evidence supporting these guidelines applied to patients older than 70 years. They found that the randomized trials that support the treatment recommendations enrolled few adults with the characteristics of a nationally representative sample of older adults with chronic kidney disease. They concluded that the evidence supporting current guidelines has limited relevance to most patients with chronic kidney disease who are older than 70 years.

Perspectives

  • The Demise of Primary Care: A Diatribe From the Trenches

    • David D. Norenberg
    Ann Intern Med May 19, 2009 150:725-726; doi:10.1059/0003-4819-150-10-200905190-00011

    Norenberg states that “primary care is dying.” In this article, he discusses the reasons why medical school graduates are avoiding primary care. One reason, he believes, is “the progressive devaluation of individualized clinical judgment.” The author suggests a solution: a pilot program in which volunteer, salaried internists are commissioned to Medicare.

Clinical Guidelines

  • Screening for Syphilis Infection in Pregnancy: U.S. Preventive Services Task Force Reaffirmation Recommendation Statement

    • U.S. Preventive Services Task Force
    Ann Intern Med May 19, 2009 150:705-709; doi:10.1059/0003-4819-150-10-200905190-00008

    The U.S. Preventive Services Task Force (USPSTF) updates its 2004 recommendation statement on screening for syphilis in pregnancy. After a targeted literature search for evidence, the Task Force recommends that clinicians screen all pregnant women for syphilis infection (A recommendation).

  • Screening for Syphilis Infection in Pregnant Women: Evidence for the U.S. Preventive Services Task Force Reaffirmation Recommendation Statement

    • Tracy Wolff,
    • Erica Shelton,
    • Cecili Sessions,
    • and Therese Miller
    Ann Intern Med May 19, 2009 150:710-716; doi:10.1059/0003-4819-150-10-200905190-00009

    To support the USPSTF recommendation statement in this issue, Wolff and colleagues systematically reviewed the evidence on the benefits and harms of screening for syphilis in pregnancy and the harms of treatment with penicillin. They found new evidence from a study of universal screening that supports previous evidence that screening for syphilis in pregnancy prevents congenital syphilis. Harms include testing and follow-up for false-positive test results and adverse effects from penicillin treatment.

Editorials

  • Evaluating the President's Emergency Plan for AIDS Relief: Time to Scale It Up

    • Robert Gross and
    • Gregory Bisson
    Ann Intern Med May 19, 2009 150:727-728; doi:10.1059/0003-4819-150-10-200905190-00012

    In this issue, Bendavid and Bhattacharya attempt to measure the effects of PEPFAR by comparing trends in AIDS-related death rates and HIV prevalence rates in 12 PEPFAR focus and 29 nonfocus African countries with a generalized HIV epidemic. Their results are not surprising, but the most important contribution of the article is to highlight many of the challenges of evaluating a nonrandomized, complex, global health care intervention, such as PEPFAR.

  • Quality Wrapped in Volume Inside a Hospital

    • Peter B. Bach
    Ann Intern Med May 19, 2009 150:729-730; doi:10.1059/0003-4819-150-10-200905190-00013

    Auerbach and colleagues' findings in this issue are an important contribution to the literature on both quality of care and the relation between volume and outcome, but their study is another grim reminder of how often hospitals do not take the most basic steps to enhance patient outcomes after a frequently performed major procedure.

  • Does Evidence Support Renin–Angiotensin System Blockade for Slowing Nephropathy Progression in Elderly Persons?

    • Pantelis A. Sarafidis and
    • George L. Bakris
    Ann Intern Med May 19, 2009 150:731-733; doi:10.1059/0003-4819-150-10-200905190-00014

    In this issue, O'Hare and colleagues asked whether current guidelines on hypertension treatment of chronic kidney disease apply to patients older than 70 years. They show that older adults are poorly represented in randomized, controlled trials of chronic kidney disease progression, and highlight an important unanswered question about chronic kidney disease staging: the application of the Modification of Diet in Renal Disease Study equation to elderly persons.

On Being a Doctor

  • The Name of a Champion

    • Adam D. Falchook
    Ann Intern Med May 19, 2009 150:734; doi:10.1059/0003-4819-150-10-200905190-00015

Letters

  • Do Reference Standards Hold Back the Progress of Medicine?

    • Yvo M. Smulders and
    • Abel Thijs
    Ann Intern Med May 19, 2009 150:735; doi:10.1059/0003-4819-150-10-200905190-00016

  • Do Reference Standards Hold Back the Progress of Medicine?

    • Paul Glasziou,
    • Les Irwig,
    • and Jonathan Deeks
    Ann Intern Med May 19, 2009 150:735-736; doi:10.1059/0003-4819-150-10-200905190-00017

  • Questions About Genetic Variation in 9p21 as a Predictor of Cardiovascular Risk

    • Jeff Gulcher and
    • Kari Stefansson
    Ann Intern Med May 19, 2009 150:736; doi:10.1059/0003-4819-150-10-200905190-00018

  • Questions About Genetic Variation in 9p21 as a Predictor of Cardiovascular Risk

    • Lukasz Kiljanek
    Ann Intern Med May 19, 2009 150:736; doi:10.1059/0003-4819-150-10-200905190-00019

  • Questions About Genetic Variation in 9p21 as a Predictor of Cardiovascular Risk

    • John R. Schwarzenbach
    Ann Intern Med May 19, 2009 150:736; doi:10.1059/0003-4819-150-10-200905190-00020

  • Questions About Genetic Variation in 9p21 as a Predictor of Cardiovascular Risk

    • Nina P. Paynter,
    • Nancy R. Cook,
    • and Paul M Ridker
    Ann Intern Med May 19, 2009 150:737; doi:10.1059/0003-4819-150-10-200905190-00021

  • The First Use of Penicillin in the United States

    • Charles M. Grossman
    Ann Intern Med May 19, 2009 150:737; doi:10.1059/0003-4819-150-10-200905190-00022

  • Reversal of Haloperidol-Induced Cardiac Arrest by Using Lipid Emulsion

    • Guy Weinberg,
    • Guido Di Gregorio,
    • David Hiller,
    • Agnes Hewett,
    • and Archie Sirianni
    Ann Intern Med May 19, 2009 150:737-738; doi:10.1059/0003-4819-150-10-200905190-00023

  • Use of Levosimendan for Treatment of Cardiogenic Shock Associated With Electrical Storm

    • Marco Grazi,
    • Gianfranco Lauri,
    • Corrado Carbucicchio,
    • and Giancarlo Marenzi
    Ann Intern Med May 19, 2009 150:738-740; doi:10.1059/0003-4819-150-10-200905190-00024

Medical Notices

  • Medical Notices

    Ann Intern Med May 19, 2009 150:0; doi:10.1059/0003-4819-150-9-0000605-200905190-00025

Summaries for Patients

  • The Effects of Splinting on Thumb Arthritis

    Ann Intern Med May 19, 2009 150:I-34; doi:10.1059/0003-4819-150-10-200905190-00001

  • Screening Pregnant Women for Syphilis Infection: U.S. Preventive Services Task Force Recommendation

    Ann Intern Med May 19, 2009 150:I-40; doi:10.1059/0003-4819-150-10-200905190-00002

ACP Journal Club

  • Editorial: What kind of randomized trials do patients and clinicians need?

    Ann Intern Med May 19, 2009 150:JC5-2; doi:10.1059/0003-4819-150-10-200905190-02002

  • Review: Pneumococcal vaccination is not effective for preventing pneumonia, bacteremia, bronchitis, or mortality

    Ann Intern Med May 19, 2009 150:JC5-4; doi:10.1059/0003-4819-150-10-200905190-02004

  • Selective decontamination of the digestive tract and selective oropharyngeal decontamination reduced mortality in the ICU

    Ann Intern Med May 19, 2009 150:JC5-5; doi:10.1059/0003-4819-150-10-200905190-02005

  • Review: Evidence is insufficient to evaluate effectiveness of antiviral therapies for chronic hepatitis B

    Ann Intern Med May 19, 2009 150:JC5-6; doi:10.1059/0003-4819-150-10-200905190-02006

  • Fractional flow reserve–guided PCI reduced major adverse cardiac outcomes compared with angiography-guided PCI in multivessel CAD

    Ann Intern Med May 19, 2009 150:JC5-7; doi:10.1059/0003-4819-150-10-200905190-02007

  • Benazepril plus amlodipine reduced cardiovascular risk more than benazepril plus hydrochlorothiazide

    Ann Intern Med May 19, 2009 150:JC5-8; doi:10.1059/0003-4819-150-10-200905190-02008

  • Intensive primary care treatment reduced cardiovascular risk factors at 1 year in screen-detected type 2 diabetes

    Ann Intern Med May 19, 2009 150:JC5-9; doi:10.1059/0003-4819-150-10-200905190-02009

  • Irbesartan did not reduce all-cause death or CV hospitalization in heart failure and preserved ejection fraction

    Ann Intern Med May 19, 2009 150:JC5-10; doi:10.1059/0003-4819-150-10-200905190-02010

  • Review: Adding dexamethasone to standard therapy reduces short-term relapse for acute migraine in the emergency department

    Ann Intern Med May 19, 2009 150:JC5-11; doi:10.1059/0003-4819-150-10-200905190-02011

  • Review: Computed tomography angiography is highly accurate for diagnosing significant stenosis in peripheral arterial disease

    Ann Intern Med May 19, 2009 150:JC5-12; doi:10.1059/0003-4819-150-10-200905190-02012

  • Implementation of an evidence-based feeding guideline did not reduce mortality in intensive care units

    Ann Intern Med May 19, 2009 150:JC5-13; doi:10.1059/0003-4819-150-10-200905190-02013

  • The Glasgow-Blatchford Bleeding Score identified patients with upper GI bleeding who could be managed as outpatients

    Ann Intern Med May 19, 2009 150:JC5-14; doi:10.1059/0003-4819-150-10-200905190-02014

  • Absolute CVD risk, stratified by risk score, was 20% higher in primary care patients with CVD than in those without CVD

    Ann Intern Med May 19, 2009 150:JC5-15; doi:10.1059/0003-4819-150-10-200905190-02015

  • Correction

    Ann Intern Med May 19, 2009 150:JC5-15; doi:10.1059/0003-4819-150-10-200905190-02017

  • Glossary

    Ann Intern Med May 19, 2009 150:JC5-16; doi:10.1059/0003-4819-150-10-200905190-02016
« Previous | Next Issue »

This Issue

May 19, 2009; 150 (10)
  1. Articles
  2. Improving Patient Care
  3. Academia and Clinic
  4. Perspectives
  5. Clinical Guidelines
  6. Editorials
  7. On Being a Doctor
  8. Letters
  9. Medical Notices
  10. Summaries for Patients
  11. ACP Journal Club

Search in this issue:

Current Issue

  1. November 17, 2009, 151 (10)
  1. Alert me to current issues