Table of Contents

March 17, 2009; 150 (6)

Articles

  • B-Type Natriuretic Peptide Testing, Clinical Outcomes, and Health Services Use in Emergency Department Patients With Dyspnea: A Randomized Trial

    • Hans-Gerhard Schneider,
    • Louisa Lam,
    • Amaali Lokuge,
    • Henry Krum,
    • Matthew T. Naughton,
    • Pieter De Villiers Smit,
    • Adam Bystrzycki,
    • David Eccleston,
    • Jacob Federman,
    • Genevieve Flannery,
    • and Peter Cameron
    Ann Intern Med March 17, 2009 150:365-371; doi:10.1059/0003-4819-150-6-200903170-00004

    B-type natriuretic peptide (BNP) testing is commonly used to distinguish cardiac from noncardiac causes of dyspnea. In this randomized trial, BNP testing did not reduce health services utilization or improve health outcomes for dyspneic patients who visited emergency departments. Measuring BNP in all dyspneic patients to see whether heart failure is a cause of their symptoms may not be justified.

  • Trajectories of Life-Space Mobility After Hospitalization

    • Cynthia J. Brown,
    • David L. Roth,
    • Richard M. Allman,
    • Patricia Sawyer,
    • Christine S. Ritchie,
    • and Jeffrey M. Roseman
    Ann Intern Med March 17, 2009 150:372-378; doi:10.1059/0003-4819-150-6-200903170-00005

    Life space (a measure of where a person goes, how frequently, and how independently) may more accurately measure physical function in older adults because it also reflects participation in society. Brown and colleagues found a reduction in self-reported life space in hospitalized older adults. Patients who required surgery had greater immediate declines but more rapid recovery than did those hospitalized for other reasons.

  • Aspirin to Prevent Cardiovascular Disease: The Association of Aspirin Dose and Clopidogrel With Thrombosis and Bleeding

    • Steven R. Steinhubl,
    • Deepak L. Bhatt,
    • Danielle M. Brennan,
    • Gilles Montalescot,
    • Graeme J. Hankey,
    • John W. Eikelboom,
    • Peter B. Berger,
    • Eric J. Topol,
    • and on behalf of the CHARISMA Investigators
    Ann Intern Med March 17, 2009 150:379-386; doi:10.1059/0003-4819-150-6-200903170-00006

    This post hoc analysis of data from a randomized trial suggests that the dose of aspirin used to prevent cardiovascular events does not affect efficacy or safety. However, in patients randomly assigned to clopidogrel, higher aspirin doses seemed to be associated with reduced efficacy and increased harm. Lower aspirin doses (75 to 81 mg/d) seem to optimize efficacy and safety for patients requiring aspirin for long-term prevention, especially those taking clopidogrel.

Perspectives

  • Nursing Home Physician Specialists: A Response to the Workforce Crisis in Long-Term Care

    • Paul R. Katz,
    • Jurgis Karuza,
    • Orna Intrator,
    • and Vincent Mor
    Ann Intern Med March 17, 2009 150:411-413; doi:10.1059/0003-4819-150-6-200903170-00010

    Marginalization of physicians who work in nursing homes threatens the overall care of nursing home residents with medically complex illnesses. Katz and associates propose creating a nursing home medicine specialty that recognizes the nursing home as a unique practice site. They characterize the specialty in 3 dimensions and discuss the implications for quality of care, health policy, and research needs.

Clinical Guidelines

  • QTc Interval Screening in Methadone Treatment

    • Mori J. Krantz,
    • Judith Martin,
    • Barry Stimmel,
    • Davendra Mehta,
    • and Mark C.P. Haigney
    Ann Intern Med March 17, 2009 150:387-395; doi:10.1059/0003-4819-150-6-200903170-00103

    An expert panel met to develop safety recommendations for prescribing methadone, which can be associated with prolongation of the QT interval and an increased risk for torsade de pointes. Panelists recommended that clinicians inform patients of arrhythmia risk when they prescribe methadone and ask about a history of heart disease. They also recommend that patients have pretreatment and follow-up electrocardiography. Possible actions if the rate-corrected QT interval is greater than 450 ms or 500 ms include discussion of the risks and benefits of methadone, more frequent monitoring, dose reduction, or stopping methadone treatment. Finally, clinicians should learn about interactions between methadone and other drugs that can prolong the QT interval or slow elimination of methadone.

  • Aspirin for the Prevention of Cardiovascular Disease: U.S. Preventive Services Task Force Recommendation Statement

    • U.S. Preventive Services Task Force
    Ann Intern Med March 17, 2009 150:396-404; doi:10.1059/0003-4819-150-6-200903170-00008

    The U.S. Preventive Services Task Force (USPSTF) recommends encouraging men age 45 to 79 years and women age 55 to 79 years to use aspirin when the potential benefit of a reduction in myocardial infarctions and ischemic strokes, respectively, outweighs the potential harm of increased risk for gastrointestinal hemorrhage (A recommendations). It discourages men and women younger than these ages from using aspirin for cardiovascular disease prevention (D recommendation). Evidence is insufficient to assess the balance of benefits and harms of aspirin use for cardiovascular disease prevention in men and women older than 79 years (I statement).

  • Aspirin for the Primary Prevention of Cardiovascular Events: An Update of the Evidence for the U.S. Preventive Services Task Force

    • Tracy Wolff,
    • Therese Miller,
    • and Stephen Ko
    Ann Intern Med March 17, 2009 150:405-410; doi:10.1059/0003-4819-150-6-200903170-00009

    To support the USPSTF recommendation in this issue, Wolff and colleagues reviewed new evidence on the benefits and harms of aspirin for the primary prevention of cardiovascular disease. They conclude that aspirin reduces the risk for myocardial infarction in men and strokes in women but increases the risk for serious bleeding events, primarily gastrointestinal bleeding events.

Editorials

  • Aspirin for Prevention and Treatment of Cardiovascular Disease

    • Shamir R. Mehta
    Ann Intern Med March 17, 2009 150:414-416; doi:10.1059/0003-4819-150-6-200903170-00011

    In this issue, 2 studies shed light on key questions related to aspirin use. Steinhubl and colleagues investigated the optimal dose of aspirin for prevention and treatment of cardiovascular disease, and they found that higher doses do not lead to improved efficacy and may be associated with more bleeding. The updated USPSTF recommendation on the use of aspirin for the primary prevention of coronary heart disease is an important and user-friendly document for the busy clinician.

  • First Do No Harm … Reduction?

    • Marc N. Gourevitch
    Ann Intern Med March 17, 2009 150:417-418; doi:10.1059/0003-4819-150-6-200903170-00111

    An expert panel convened to discuss how to incorporate methadone's possible effect on the QT interval into clinical practice. The findings and recommendations of some of the panel members appear in this issue. They wade into controversial territory by recommending that physicians obtain electrocardiograms before treatment initiation, at 30 days, and annually thereafter in all patients receiving methadone. Before guidelines are implemented, research methods, such as decision analysis, should be applied to permit clear appreciation of the tradeoffs, benefits, and harms of alternative screening strategies.

On Being a Doctor

  • Lost in Translation

    • Mark Saxena
    Ann Intern Med March 17, 2009 150:419-420; doi:10.1059/0003-4819-150-6-200903170-00013

  • Just Playing Doctor

    • David Alex Stroh
    Ann Intern Med March 17, 2009 150:421-422; doi:10.1059/0003-4819-150-6-200903170-00014

Letters

  • Questioning the Accuracy of a Recent Review of Osteoporosis Medications

    • Laura N. Kuhl,
    • Bruce Ettinger,
    • Clifford J. Rosen,
    • and Nananda F. Col
    Ann Intern Med March 17, 2009 150:423-424; doi:10.1059/0003-4819-150-6-200903170-00015

  • Questioning the Accuracy of a Recent Review of Osteoporosis Medications

    • Catherine MacLean and
    • Marika Suttorp
    Ann Intern Med March 17, 2009 150:424-425; doi:10.1059/0003-4819-150-6-200903170-00016

  • How Much Did Biases in the Study of Chronic Obstructive Pulmonary Disease Medications and Mortality Affect the Outcome?

    • Samy Suissa and
    • Pierre Ernst
    Ann Intern Med March 17, 2009 150:425-426; doi:10.1059/0003-4819-150-6-200903170-00017

  • How Much Did Biases in the Study of Chronic Obstructive Pulmonary Disease Medications and Mortality Affect the Outcome?

    • Nicholas J. Gross
    Ann Intern Med March 17, 2009 150:426; doi:10.1059/0003-4819-150-6-200903170-00018

  • How Much Did Biases in the Study of Chronic Obstructive Pulmonary Disease Medications and Mortality Affect the Outcome?

    • Takeharu Koga,
    • Tomoko Kamimura,
    • and Munetsugu Nishimura
    Ann Intern Med March 17, 2009 150:426; doi:10.1059/0003-4819-150-6-200903170-00019

  • How Much Did Biases in the Study of Chronic Obstructive Pulmonary Disease Medications and Mortality Affect the Outcome?

    • Todd A. Lee,
    • A. Simon Pickard,
    • and David H. Au
    Ann Intern Med March 17, 2009 150:426-427; doi:10.1059/0003-4819-150-6-200903170-00020

  • Are Risk Stratification Tables the Best Way to Evaluate Model Performance?

    • Ralph H. Stern and
    • Dean E. Smith
    Ann Intern Med March 17, 2009 150:427-428; doi:10.1059/0003-4819-150-6-200903170-00021

  • Are Risk Stratification Tables the Best Way to Evaluate Model Performance?

    • Holly Janes,
    • Margaret S. Pepe,
    • and Wen Gu
    Ann Intern Med March 17, 2009 150:428; doi:10.1059/0003-4819-150-6-200903170-00022

  • The Predictive Value of the ELISpot-Based Interferon-[ggr ]–Release Assay for Tuberculosis Disease

    • Anneke C. Hesseling,
    • Robert P. Gie,
    • and Anna M. Mandalakas
    Ann Intern Med March 17, 2009 150:428-429; doi:10.1059/0003-4819-150-6-200903170-00023

  • The Predictive Value of the ELISpot-Based Interferon-[ggr ]–Release Assay for Tuberculosis Disease

    • Ajit Lalvani and
    • Kerry A. Millington
    Ann Intern Med March 17, 2009 150:429-430; doi:10.1059/0003-4819-150-6-200903170-00024

  • Challenges in Reporting Meta-analyses of Diagnostic Accuracy Studies

    • Levente Kriston,
    • Martin Härter,
    • and Lars Hölzel
    Ann Intern Med March 17, 2009 150:430; doi:10.1059/0003-4819-150-6-200903170-00025

  • Chronic Hepatitis After Hepatitis E Virus Infection in a Patient With Non-Hodgkin Lymphoma Taking Rituximab

    • Laurence Ollier,
    • Nathalie Tieulie,
    • Frédérick Sanderson,
    • Philippe Heudier,
    • Valérie Giordanengo,
    • Jean-Gabriel Fuzibet,
    • and Elisabeth Nicand
    Ann Intern Med March 17, 2009 150:430-431; doi:10.1059/0003-4819-150-6-200903170-00026

  • Incidence of Asymptomatic Patent Foramen Ovale According to Age

    • Stephen A. Hart and
    • Richard A. Krasuski
    Ann Intern Med March 17, 2009 150:431-432; doi:10.1059/0003-4819-150-6-200903170-00027

  • Correction: 3 February Personae

    Ann Intern Med March 17, 2009 150:432; doi:10.1059/0003-4819-150-6-200903170-00028

  • Correction: Immediate Listing for Liver Transplantation for Alcoholic Cirrhosis

    Ann Intern Med March 17, 2009 150:432; doi:10.1059/0003-4819-150-6-200903170-00029

  • Correction: Entecavir to Treat Hepatitis B–Associated Cryoglobulinemic Vasculitis

    Ann Intern Med March 17, 2009 150:432; doi:10.1059/0003-4819-150-6-200903170-00030

Current Clinical Issues

  • More Cases of Drug-Resistant Tuberculosis Complicate Care but Spur Global Research and Innovation

    • Jennifer Fisher Wilson
    Ann Intern Med March 17, 2009 150:433-436; doi:10.1059/0003-4819-150-6-200903170-00031

Medical Notices

  • Medical Notices

    Ann Intern Med March 17, 2009 150:0; doi:10.1059/0003-4819-150-5-200903170-00032

Summaries for Patients

  • What Aspirin Dose Is Safest and Most Effective for Preventing Heart Disease?

    Ann Intern Med March 17, 2009 150:I-22; doi:10.1059/0003-4819-150-6-200903170-00001

  • QTc Interval Screening in Methadone Treatment

    Ann Intern Med March 17, 2009 150:I-26; doi:10.1059/0003-4819-150-1-200903170-00104

  • Aspirin for the Prevention of Cardiovascular Disease: U.S. Preventive Services Task Force Recommendation Statement

    Ann Intern Med March 17, 2009 150:I-37; doi:10.1059/0003-4819-150-6-200903170-00003

ACP Journal Club

  • Editorial: What does it take to put an ugly fact through the heart of a beautiful hypothesis?

    Ann Intern Med March 17, 2009 150:JC3-2; doi:10.1059/0003-4819-150-6-200903170-02002

  • Review: Perioperative β-blockers provide no clear benefit in patients having noncardiac surgery

    Ann Intern Med March 17, 2009 150:JC3-4; doi:10.1059/0003-4819-150-6-200903170-02004

  • Review: Long-acting β-agonists do not increase risk for asthma-related hospitalization in patients taking inhaled corticosteroids

    Ann Intern Med March 17, 2009 150:JC3-5; doi:10.1059/0003-4819-150-6-200903170-02005

  • Review: Inhaled corticosteroids do not reduce mortality but increase pneumonia in chronic obstructive pulmonary disease

    Ann Intern Med March 17, 2009 150:JC3-6; doi:10.1059/0003-4819-150-6-200903170-02006

  • Review: Enhanced oral hygiene prevents respiratory infection in older persons in hospitals and nursing homes

    Ann Intern Med March 17, 2009 150:JC3-7; doi:10.1059/0003-4819-150-6-200903170-02007

  • Intensive and standard glucose control did not differ for major CV events or death in poorly controlled type 2 diabetes

    Ann Intern Med March 17, 2009 150:JC3-8; doi:10.1059/0003-4819-150-6-200903170-02008

  • Combined therapy with folic acid and vitamins B6 and B12 did not affect cancer risk in women at high risk for CV disease

    Ann Intern Med March 17, 2009 150:JC3-9; doi:10.1059/0003-4819-150-6-200903170-02009

  • Selenium and vitamin E, alone or together, did not prevent prostate cancer

    Ann Intern Med March 17, 2009 150:JC3-10; doi:10.1059/0003-4819-150-6-200903170-02010

  • Vitamin E and vitamin C, alone or together, did not prevent prostate or total cancer in men

    Ann Intern Med March 17, 2009 150:JC3-11; doi:10.1059/0003-4819-150-6-200903170-02011

  • Prednisolone, but not valacyclovir, reduced time to complete recovery of facial-nerve function in Bell palsy

    Ann Intern Med March 17, 2009 150:JC3-12; doi:10.1059/0003-4819-150-6-200903170-02012

  • Review: Combinations of clinical findings had moderate sensitivity and specificity for diagnosing the irritable bowel syndrome

    Ann Intern Med March 17, 2009 150:JC3-13; doi:10.1059/0003-4819-150-6-200903170-02013

  • Reynolds Risk Score for men predicted cardiovascular events more accurately than traditional risk factors only

    Ann Intern Med March 17, 2009 150:JC3-14; doi:10.1059/0003-4819-150-6-200903170-02014

  • Simplification of the revised Geneva score did not decrease accuracy for diagnosis of pulmonary embolism

    Ann Intern Med March 17, 2009 150:JC3-15; doi:10.1059/0003-4819-150-6-200903170-02015

  • Glossary

    Ann Intern Med March 17, 2009 150:JC3-16; doi:10.1059/0003-4819-150-6-200903170-02016
« Previous | Next Issue »

This Issue

March 17, 2009; 150 (6)
  1. Articles
  2. Perspectives
  3. Clinical Guidelines
  4. Editorials
  5. On Being a Doctor
  6. Letters
  7. Current Clinical Issues
  8. Medical Notices
  9. Summaries for Patients
  10. ACP Journal Club

Search in this issue:

Current Issue

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