Table of Contents

April 7, 2009; 150 (7)

Articles

  • Effect of Varying Levels of Disease Management on Smoking Cessation: A Randomized Trial

    • Edward F. Ellerbeck,
    • Jonathan D. Mahnken,
    • A. Paula Cupertino,
    • Lisa Sanderson Cox,
    • K. Allen Greiner,
    • Laura M. Mussulman,
    • Niaman Nazir,
    • Theresa I. Shireman,
    • Kenneth Resnicow,
    • and Jasjit S. Ahluwalia
    Ann Intern Med April 7, 2009 150:437-446; doi:10.1059/0003-4819-150-7-200904070-00003

    Successful smoking cessation may require repeated or intensive interventions. In this multicenter trial, 750 primary care patients who smoked at least 10 cigarettes daily were randomly assigned to pharmacotherapy (nicotine patch or bupropion), pharmacotherapy supplemented with up to 2 calls from trained counselors, or pharmacotherapy supplemented with up to 6 counseling calls. Abstinence over the 24-month study was highest in the high-intensity counseling group. Point prevalences of abstinence at 2 years were 23%, 24%, and 28%, respectively.

  • Triple-Combination Pharmacotherapy for Medically Ill Smokers: A Randomized Trial

    • Michael B. Steinberg,
    • Shelley Greenhaus,
    • Amy C. Schmelzer,
    • Michelle T. Bover,
    • Jonathan Foulds,
    • Donald R. Hoover,
    • and Jeffrey L. Carson
    Ann Intern Med April 7, 2009 150:447-454; doi:10.1059/0003-4819-150-7-200904070-00004

    Few studies have examined interventions for smokers with medical illnesses. In this trial, 127 smokers with such conditions as cardiovascular disease or chronic obstructive pulmonary disease were randomly assigned to receive a nicotine patch for 10 weeks or a combination of a nicotine patch, a nicotine oral inhaler, and bupropion for as long as required. Abstinence rates at 26 weeks for the nicotine patch and combination therapy groups were 19% and 35%, respectively. Insomnia (25% vs. 9%) and anxiety (22% vs. 3%) were more common with combination therapy.

  • Intravenous Esomeprazole for Prevention of Recurrent Peptic Ulcer Bleeding: A Randomized Trial

    • Joseph J.Y. Sung,
    • Alan Barkun,
    • Ernst J. Kuipers,
    • Joachim Mössner,
    • Dennis M. Jensen,
    • Robert Stuart,
    • James Y. Lau,
    • Henrik Ahlbom,
    • Jan Kilhamn,
    • Tore Lind,
    • and for the Peptic Ulcer Bleed Study Group
    Ann Intern Med April 7, 2009 150:455-464; doi:10.1059/0003-4819-150-7-200904070-00105

    Most studies of high-dose proton-pump inhibitors after endoscopic treatment of peptic bleeding ulcers have included largely Asian study populations. This multicenter trial included 764 adults from largely Western countries who had a single high-risk bleeding gastric or duodenal ulcer. All patients had successful endoscopic hemostasis and were randomly assigned to receive intravenous high-dose esomeprazole or matching placebo for 72 hours. Fewer esomeprazole recipients than placebo recipients experienced recurrent bleeding (5.9% vs. 10.3%) or needed endoscopic re-treatment (6.4% vs. 11.6%).

  • Impact of Age and Comorbidity on Colorectal Cancer Screening Among Older Veterans

    • Louise C. Walter,
    • Karla Lindquist,
    • Sean Nugent,
    • Tammy Schult,
    • Sei J. Lee,
    • Michele A. Casadei,
    • and Melissa R. Partin
    Ann Intern Med April 7, 2009 150:465-473; doi:10.1059/0003-4819-150-7-200904070-00006

    Guidelines increasingly state that screening for cancer should target people who will live long enough to benefit from it. Among 27 068 screen-eligible Veterans Affairs patients age 70 years or older, 47% of those with no comorbidity (5-year mortality, 19%) and 41% with severe comorbidity (5-year mortality, 55%) received colorectal cancer screening. Rates were somewhat lower for older men but varied only slightly by life expectancy. In this population of elderly men, screening did not target healthier patients.

Review

  • Systematic Review: Association of Low-Density Lipoprotein Subfractions With Cardiovascular Outcomes

    • Stanley Ip,
    • Alice H. Lichtenstein,
    • Mei Chung,
    • Joseph Lau,
    • and Ethan M. Balk
    Ann Intern Med April 7, 2009 150:474-484; doi:10.1059/0003-4819-150-7-200904070-00007

    Low-density lipoprotein (LDL) subfractions differ in size and may differ in the strength of association with cardiovascular disease. The authors reviewed 24 published studies that reported relationships between LDL subfractions and cardiovascular outcomes. Higher LDL particle concentration is consistently associated with increased risk for cardiovascular disease, independent of other lipid measurements. The LDL particle size is generally not associated with cardiovascular disease. Routine use of clinically available LDL subfraction tests to estimate cardiovascular disease risk is premature.

Medicine and Public Issues

  • The Obama Administration's Options for Health Care Cost Control: Hope Versus Reality

    • Theodore Marmor,
    • Jonathan Oberlander,
    • and Joseph White
    Ann Intern Med April 7, 2009 150:485-489; doi:10.1059/0003-4819-150-7-200904070-00114

    The authors argue that the Obama administration's approach to reducing health care costs has some potential for cost control but also includes strategies that are not likely to be successful. They discuss lessons that the United States can learn from other countries' successes, which focus on lowering the administrative costs of health insurance, negotiating lower prices with providers, and establishing global budgets for health care.

  • The Expanding Medical and Behavioral Resources with Access to Care for Everyone Health Plan

    • Gilead I Lancaster,
    • Ryan O'Connell,
    • David L. Katz,
    • JoAnn E. Manson,
    • William R. Hutchison,
    • Charles Landau,
    • Kimberly A. Yonkers,
    • and for Healthcare Professionals for Healthcare Reform
    Ann Intern Med April 7, 2009 150:490-492; doi:10.1059/0003-4819-150-7-200904070-00113

    Healthcare Professionals for Healthcare Reform is a group of physicians and others who convened to propose a universal health care plan that builds on the strengths of the U.S. health care system and improves on its coverage, efficiency, and capacity for patient choice. The group proposes a 3-tiered health care coverage plan and makes suggestions for oversight of this plan.

  • Toward a 21st-Century Health Care System: Recommendations for Health Care Reform

    • Kenneth Arrow,
    • Alan Auerbach,
    • John Bertko,
    • Shannon Brownlee,
    • Lawrence P. Casalino,
    • Jim Cooper,
    • Francis J. Crosson,
    • Alain Enthoven,
    • Elizabeth Falcone,
    • Robert C. Feldman,
    • Victor R. Fuchs,
    • Alan M. Garber,
    • Marthe R. Gold,
    • Dana Goldman,
    • Gillian K. Hadfield,
    • Mark A. Hall,
    • Ralph I. Horwitz,
    • Michael Hooven,
    • Peter D. Jacobson,
    • Timothy Stoltzfus Jost,
    • Lawrence J. Kotlikoff,
    • Jonathan Levin,
    • Sharon Levine,
    • Richard Levy,
    • Karen Linscott,
    • Harold S. Luft,
    • Robert Mashal,
    • Daniel McFadden,
    • David Mechanic,
    • David Meltzer,
    • Joseph P. Newhouse,
    • Roger G. Noll,
    • Jan B. Pietzsch,
    • Philip Pizzo,
    • Robert D. Reischauer,
    • Sara Rosenbaum,
    • William Sage,
    • Leonard D. Schaeffer,
    • Edward Sheen,
    • B. Michael Silber,
    • Jonathan Skinner,
    • Stephen M. Shortell,
    • Samuel O. Thier,
    • Sean Tunis,
    • Lucien Wulsin, Jr.,
    • Paul Yock,
    • Gabi Bin Nun,
    • Stirling Bryan,
    • Osnat Luxenburg,
    • and Wynand P.M.M. van de Ven
    Ann Intern Med April 7, 2009 150:493-495; doi:10.1059/0003-4819-150-7-200904070-00115

    The FRESH-Thinking Project held a series of workshops during which physicians, health policy experts, health insurance executives, business leaders, hospital administrators, economists, and others who represent diverse perspectives discussed approaches to successful, sustainable health care reform. This group presents 8 recommendations that it believes are fundamental to successful reform.

Editorials

  • The Future of Tobacco Treatment in the Health Care System

    • Nancy A. Rigotti
    Ann Intern Med April 7, 2009 150:496-497; doi:10.1059/0003-4819-150-7-200904070-00011

    Two articles in this issue aim to improve the population impact of existing tobacco treatment: Ellerbeck and colleagues focused on improving the reach of treatment, and Steinberg and associates tested a strategy to improve the effectiveness of existing treatments. Each describes a cutting-edge strategy that health care providers and health care systems could use to reduce the enormous health and economic burden of tobacco use.

  • Perspectives on Health Care Reform

    • The Editors
    Ann Intern Med April 7, 2009 150:498; doi:10.1059/0003-4819-150-7-200904070-00116

    In this issue, articles by Marmor and colleagues, Lancaster and associates, and Arrow and coworkers generate dialogue about the way forward in health care reform. The Editors further invite readers to share their opinions on these 3 perspectives by joining the forum for dialogue on health care reform on http://www.annals.org/healthcarereform/.

On Being a Doctor

  • The Long Goodbye

    • Sherry A. Guardiano
    Ann Intern Med April 7, 2009 150:499-500; doi:10.1059/0003-4819-150-7-200904070-00013

Letters

  • Starvation Diets as a Cause of Acquired Long QT Syndrome

    • Daniel Bogdanov Petrov
    Ann Intern Med April 7, 2009 150:501; doi:10.1059/0003-4819-150-7-200904070-00014

  • Transient Apical Ballooning Syndrome Precipitated by Dobutamine Stress Testing

    • Adam H. Skolnick,
    • Krista Michelin,
    • Ambika Nayar,
    • Daniel Fisher,
    • and Itzhak Kronzon
    Ann Intern Med April 7, 2009 150:501-502; doi:10.1059/0003-4819-150-7-200904070-00015

  • Metoclopramide as a Possible Cause of Prolonged QT Syndrome and Torsade de Pointes in a Patient With Heart Failure and Renal Insufficiency

    • Sultan M. Siddique,
    • Nasir Shariff,
    • Nimesh Vesuwala,
    • and Tariq Hafiz
    Ann Intern Med April 7, 2009 150:502-504; doi:10.1059/0003-4819-150-7-200904070-00016

  • Correction: Clinical Implications of Short-Term Variability in Liver Function Test Results

    • Mariana Lazo
    Ann Intern Med April 7, 2009 150:504; doi:10.1059/0003-4819-150-7-200904070-00017

  • Correction: In The Clinic: Alcohol Use

    Ann Intern Med April 7, 2009 150:504; doi:10.1059/0003-4819-150-7-200904070-00018

Medical Notices

  • Medical Notices

    Ann Intern Med April 7, 2009 150:0; doi:10.1059/0003-4819-150-7-00904070-00019

Summaries for Patients

  • Comparison of 3 Strategies to Quit Smoking

    Ann Intern Med April 7, 2009 150:I-36; doi:10.1059/0003-4819-150-7-200904070-00001

  • How Do Age and Comorbidity Affect the Likelihood of Being Screened for Colorectal Cancer?

    Ann Intern Med April 7, 2009 150:I-42; doi:10.1059/0003-4819-150-7-200904070-00002

In the Clinic

  • Menopause

    Ann Intern Med April 7, 2009 150:ITC4-1; doi:10.1059/0003-4819-150-7-200904070-01004

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

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This Issue

April 7, 2009; 150 (7)
  1. Articles
  2. Review
  3. Medicine and Public Issues
  4. Editorials
  5. On Being a Doctor
  6. Letters
  7. Medical Notices
  8. Summaries for Patients
  9. In the Clinic

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