Table of Contents

October 6, 2009; 151 (7)

Articles

  • Facemasks and Hand Hygiene to Prevent Influenza Transmission in Households: A Cluster Randomized Trial

    • Benjamin J. Cowling,
    • Kwok-Hung Chan,
    • Vicky J. Fang,
    • Calvin K.Y. Cheng,
    • Rita O.P. Fung,
    • Winnie Wai,
    • Joey Sin,
    • Wing Hong Seto,
    • Raymond Yung,
    • Daniel W.S. Chu,
    • Billy C.F. Chiu,
    • Paco W.Y. Lee,
    • Ming Chi Chiu,
    • Hoi Che Lee,
    • Timothy M. Uyeki,
    • Peter M. Houck,
    • J. S. Malik Peiris,
    • and Gabriel M. Leung
    Ann Intern Med October 6, 2009 151:437-446; doi:10.1059/0003-4819-151-7-200910060-00142

    Few data are available on the effectiveness of nonpharmaceutical interventions for preventing influenza virus transmission. In this cluster randomized trial of 259 people with confirmed influenza virus infection and 794 household contacts, hand washing and facemasks seemed to prevent influenza virus transmission when healthy people started these measures within 36 hours of symptom onset in an infected family member. Although adherence to the interventions varied, these findings suggest that nonpharmaceutical interventions may help to mitigate pandemic and interpandemic influenza.

  • Effects of Alcohol and Sleep Restriction on Simulated Driving Performance in Untreated Patients With Obstructive Sleep Apnea

    • Andrew Vakulin,
    • Stuart D. Baulk,
    • Peter G. Catcheside,
    • Nick A. Antic,
    • Cameron J. van den Heuvel,
    • Jillian Dorrian,
    • and R. Doug McEvoy
    Ann Intern Med October 6, 2009 151:447-455; doi:10.1059/0003-4819-151-7-200910060-00005

    Obstructive sleep apnea (OSA) is associated with sleepiness and poor concentration, symptoms that could impair driving performance. These investigators evaluated simulated driving performance in 38 patients with untreated OSA and 20 control participants under 3 conditions: unrestricted sleep, sleep restriction, and consumption of alcohol. Steering deviation during simulated driving was 40% greater among patients with OSA after sleep restriction and alcohol intake, and patients with OSA crashed more frequently than control participants overall and after sleep restriction and alcohol consumption.

  • Associations Between Structural Capabilities of Primary Care Practices and Performance on Selected Quality Measures

    • Mark W. Friedberg,
    • Kathryn L. Coltin,
    • Dana Gelb Safran,
    • Marguerite Dresser,
    • Alan M. Zaslavsky,
    • and Eric C. Schneider
    Ann Intern Med October 6, 2009 151:456-463; doi:10.1059/0003-4819-151-7-200910060-00006

    Whether practices that have structural features characteristic of patient-centered medical homes (electronic health records, enhanced access, and ongoing performance feedback) have higher performance on measures of primary care quality is unknown. In studying 412 practices and quality measures related to diabetes, depression, prevention, and overuse of selected tests and treatments, the investigators observed that use of more sophisticated electronic health records was associated with better screening and diabetes care, but other associations between structural capabilities and quality were weaker or absent.

Review

  • Systematic Review: Safety and Efficacy of Extended-Duration Antiviral Chemoprophylaxis Against Pandemic and Seasonal Influenza

    • Nayer Khazeni,
    • Dena M. Bravata,
    • Jon-Erik C. Holty,
    • Timothy M. Uyeki,
    • Christopher D. Stave,
    • and Michael K. Gould
    Ann Intern Med October 6, 2009 151:464-473; doi:10.1059/0003-4819-151-7-200910060-00143

    Neuraminidase inhibitors are a key element of public health strategies to prevent and treat pandemic influenza. This review of 7 randomized, placebo-controlled trials found that extended-duration (>4 weeks) prophylaxis with either oseltamivir or zanamivir prevented symptomatic influenza but not asymptomatic influenza virus infection. The overall number of adverse side effects was similar for patients receiving neuraminidase inhibitors or placebo, except that oseltamivir caused more nausea and vomiting. The trials included only immunocompetent white and Japanese adults.

Clinical Guidelines

  • Using Nontraditional Risk Factors in Coronary Heart Disease Risk Assessment: U.S. Preventive Services Task Force Recommendation Statement

    • U.S. Preventive Services Task Force
    Ann Intern Med October 6, 2009 151:474-482; doi:10.1059/0003-4819-151-7-200910060-00008

    The U.S. Preventive Services Task Force (USPSTF) has issued a recommendation statement on the use of 9 nontraditional risk factors (high-sensitivity C-reactive protein [CRP], ankle–brachial index, leukocyte count, fasting blood glucose level, periodontal disease, carotid intima–media thickness, coronary artery calcification on electron-beam computed tomography, homocysteine level, and lipoprotein[a] level) in assessing coronary heart disease (CHD) risk in asymptomatic persons. It concludes that the current evidence is insufficient to assess the balance of benefits and harms of using these nontraditional risk factors to screen asymptomatic men and women with no history of CHD to prevent CHD events (I statement).

  • C-Reactive Protein as a Risk Factor for Coronary Heart Disease: A Systematic Review and Meta-analyses for the U.S. Preventive Services Task Force

    • David I. Buckley,
    • Rongwei Fu,
    • Michele Freeman,
    • Kevin Rogers,
    • and Mark Helfand
    Ann Intern Med October 6, 2009 151:483-495; doi:10.1059/0003-4819-151-7-200910060-00009

    To support the USPSTF recommendation statement in this issue, Buckley and colleagues systematically reviewed evidence on the use of CRP in assessing CHD risk in persons at intermediate risk based on traditional risk factors. They found strong evidence that CRP is associated with CHD events and moderate, consistent evidence that adding CRP to risk prediction models among initially intermediate-risk persons improves risk stratification. Evidence was insufficient to assess whether reducing CRP levels prevents CHD events.

  • Emerging Risk Factors for Coronary Heart Disease: A Summary of Systematic Reviews Conducted for the U.S. Preventive Services Task Force

    • Mark Helfand,
    • David I. Buckley,
    • Michele Freeman,
    • Rongwei Fu,
    • Kevin Rogers,
    • Craig Fleming,
    • and Linda L. Humphrey
    Ann Intern Med October 6, 2009 151:496-507; doi:10.1059/0003-4819-151-7-200910060-00010

    To support the USPSTF recommendation statement in this issue, Helfand and associates evaluated the clinical usefulness of 9 new risk factors for CHD. Available evidence varied among these factors. Although CRP was the best candidate for use in screening, evidence that changes in CRP level lead to primary prevention of CHD events is inadequate. Thus, the current evidence does not support routine use of any of the 9 risk factors for further stratification of intermediate-risk persons.

Editorials

  • Annals: A Gathering Place for Internal Medicine

    • Christine Laine
    Ann Intern Med October 6, 2009 151:509-510; doi:10.1059/0003-4819-151-7-200910060-00012

    The new Editor describes her vision for the journal, including the role of technology in medical journals and Annals' future as an intellectual gathering place for internal medicine.

  • Christine Laine: Internist, Medical Journalist, and Editor, Annals of Internal Medicine—2009

    • Eric B. Larson
    Ann Intern Med October 6, 2009 151:511-512; doi:10.1059/0003-4819-151-7-200910060-00013

    The editorialist discusses the leadership of Christine Laine, Annals' new Editor, in the context of changes in Annals content over time and the future of medical journalism.

Letters

  • Redundant Data in the Meta-analysis on Helicobacter pylori Eradication

    • Alexander C. Ford and
    • Paul Moayyedi
    Ann Intern Med October 6, 2009 151:513; doi:10.1059/0003-4819-151-7-200910060-00014

  • Redundant Data in the Meta-analysis on Helicobacter pylori Eradication

    • Lorenzo Fuccio,
    • Leonardo Henry Eusebi,
    • and Franco Bazzoli
    Ann Intern Med October 6, 2009 151:513-514; doi:10.1059/0003-4819-151-7-200910060-00015

  • Granulysin as a Marker for Early Diagnosis of the Stevens–Johnson Syndrome

    • Riichiro Abe,
    • Naoya Yoshioka,
    • Junko Murata,
    • Yasuyuki Fujita,
    • and Hiroshi Shimizu
    Ann Intern Med October 6, 2009 151:514-515; doi:10.1059/0003-4819-151-7-200910060-00016

  • Localized Amyloidosis at the Site of Enfuvirtide Injection

    • Miguel Emilio Morilla,
    • Jeffrey Kocher,
    • and Marco Harmaty
    Ann Intern Med October 6, 2009 151:515-516; doi:10.1059/0003-4819-151-7-200910060-00017

  • Correction: Can Helicobacter pylori Eradication Treatment Reduce the Risk for Gastric Cancer?

    Ann Intern Med October 6, 2009 151:516; doi:10.1059/0003-4819-151-7-200910060-00018

  • Correction: Predicting Deep Venous Thrombosis in Pregnancy

    Ann Intern Med October 6, 2009 151:516; doi:10.1059/0003-4819-151-7-200910060-00019

Ad Libitum

  • What if … (Between)

    • Elisabeth S. Goodridge
    Ann Intern Med October 6, 2009 151:508; doi:10.1059/0003-4819-151-7-200910060-00011

Medical Notices

  • Medical Notices

    Ann Intern Med October 6, 2009 151:0; doi:10.1059/0003-4819-151-7-200910060-00020

Summaries for Patients

  • The Effects of Hand Washing and Facemasks on Prevention of Influenza Infection

    Ann Intern Med October 6, 2009 151:I-18; doi:10.1059/0003-4819-151-7-200910060-00001

  • The Effects of Limited Sleep and Alcohol on Driving Performance in People With Untreated Sleep Apnea

    Ann Intern Med October 6, 2009 151:I-32; doi:10.1059/0003-4819-151-7-200910060-00002

  • Using Nontraditional Risk Factors to Estimate Risk for Coronary Heart Disease

    Ann Intern Med October 6, 2009 151:I-38; doi:10.1059/0003-4819-151-7-200910060-00003

In the Clinic

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This Issue

October 6, 2009; 151 (7)
  1. Articles
  2. Review
  3. Clinical Guidelines
  4. Editorials
  5. Letters
  6. Ad Libitum
  7. Medical Notices
  8. Summaries for Patients
  9. In the Clinic

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