Table of Contents

December 1, 2009; 151 (11)

Articles

  • Medicare Spending for Previously Uninsured Adults

    • J. Michael McWilliams,
    • Ellen Meara,
    • Alan M. Zaslavsky,
    • and John Z. Ayanian
    Ann Intern Med December 1, 2009 151:757-766; doi:10.1059/0003-4819-151-11-200912010-00149

    Some policymakers hypothesize that expanded insurance coverage before age 65 years might be associated with savings once people become eligible for Medicare. McWilliams and colleagues found that adjusted annual total Medicare spending was lower among 2951 continuously insured adults aged 64 to 74 years ($4773) than among 1616 adults who were uninsured before age 65 years ($5796). Previously uninsured adults also had higher adjusted annual hospitalization rates for complications related to cardiovascular disease or diabetes and for joint replacements.

  • Survival After Bilateral Versus Single-Lung Transplantation for Idiopathic Pulmonary Fibrosis

    • Gabriel Thabut,
    • Jason D. Christie,
    • Philippe Ravaud,
    • Yves Castier,
    • Gaëlle Dauriat,
    • Gilles Jebrak,
    • Michel Fournier,
    • Guy Lesèche,
    • Raphaël Porcher,
    • and Hervé Mal
    Ann Intern Med December 1, 2009 151:767-774; doi:10.1059/0003-4819-151-11-200912010-00004

    Patients with end-stage idiopathic pulmonary fibrosis (IPF) are increasingly having bilateral rather than single-lung transplantation. In this study, after adjustment for baseline differences, survival did not differ between 2146 patients with IPF who had single-lung transplantation and 1181 patients who had bilateral lung transplantation, although causes of death differed. Single-lung transplantation conferred short-term survival benefit but long-term harm, whereas bilateral lung transplantation conferred short-term harm but long-term survival benefit.

  • Development and Validation of a Patient Self-assessment Score for Diabetes Risk

    • Heejung Bang,
    • Alison M. Edwards,
    • Andrew S. Bomback,
    • Christie M. Ballantyne,
    • David Brillon,
    • Mark A. Callahan,
    • Steven M. Teutsch,
    • Alvin I. Mushlin,
    • and Lisa M. Kern
    Ann Intern Med December 1, 2009 151:775-783; doi:10.1059/0003-4819-151-11-200912010-00005

    National guidelines disagree on who should be screened for undiagnosed diabetes, and no existing diabetes risk score is highly generalizable or widely followed. Bang and coworkers developed a new screening score to allow people to self-assess their risk for diabetes. This score is easy to use and seems to perform better than existing methods. Studies are needed to evaluate it in diverse populations in real-world settings.

Academia and Clinic

  • Sex Differences in Attainment of Independent Funding by Career Development Awardees

    • Reshma Jagsi,
    • Amy R. Motomura,
    • Kent A. Griffith,
    • Soumya Rangarajan,
    • and Peter A. Ubel
    Ann Intern Med December 1, 2009 151:804-811; doi:10.1059/0003-4819-151-11-200912010-00009

    Concerns have been raised about whether female researchers in academic medicine are as successful as men. Jagsi and associates found that although 31.4% of 1919 K08 awardees and 43.7% of 865 K23 awardees from 1997 to 2003 were female, women were less likely than men to receive an R01 award at 5 years (18.8% vs. 24.8%). Differences persisted at 10 years. Sex continued to be an independent significant predictor of R01 award attainment in multivariate analysis controlling for K award type, year of award, funding institute, institution, and specialty.

Perspectives

  • Expand the Pharyngitis Paradigm for Adolescents and Young Adults

    • Robert M. Centor
    Ann Intern Med December 1, 2009 151:812-815; doi:10.1059/0003-4819-151-11-200912010-00011

    Recent data suggest that in adolescents and young adults, Fusobacterium necrophorum causes endemic pharyngitis at a rate similar to that of group A β-hemolytic streptococci. On the basis of published epidemiologic data, the author suggests that the diagnostic paradigm for adolescent pharyngitis be expanded to consider F. necrophorum. He proposes aggressive antibiotic treatment for F. necrophorum infection in adolescents and young adults who develop bacteremic symptoms and that physicians know the red flags for pharyngitis in this group.

Clinical Guidelines

  • Screening for Depression in Adults: U.S. Preventive Services Task Force Recommendation Statement

    • U.S. Preventive Services Task Force
    Ann Intern Med December 1, 2009 151:784-792; doi:10.1059/0003-4819-151-11-200912010-00006

    The U.S. Preventive Services Task Force (USPSTF) recommends screening adults for depression when staff-assisted depression care supports are in place to assure accurate diagnosis, effective treatment, and follow-up (grade B recommendation). It recommends against routinely screening adults for depression when staff-assisted depression care supports are not in place. There may be considerations that support screening for depression in an individual patient (grade C recommendation).

  • Screening for Depression in Adult Patients in Primary Care Settings: A Systematic Evidence Review

    • Elizabeth A. O'Connor,
    • Evelyn P. Whitlock,
    • Tracy L. Beil,
    • and Bradley N. Gaynes
    Ann Intern Med December 1, 2009 151:793-803; doi:10.1059/0003-4819-151-11-200912010-00007

    To support the USPSTF recommendation statement in this issue, O'Connor and colleagues reviewed evidence on screening adults for depression in primary care, the benefits of depression treatment in older adults, and the harms of antidepressants. Primary care depression screening and care management programs with staff assistance can increase depression response and remission. No benefit was evident in screening programs without staff assistance in depression care. Antidepressant treatment does not seem to increase deaths from suicide. Risk for suicidal behavior was increased in young adults who received antidepressants, particularly paroxetine, but was reduced in older adults.

Editorials

  • Insuring the Near-Elderly: How Much Would Medicare Save?

    • Jay Bhattacharya
    Ann Intern Med December 1, 2009 151:816-817; doi:10.1059/0003-4819-151-11-200912010-00158

    In this issue, McWilliams and colleagues calculate that providing insurance to uninsured near-elderly adults would result in $98 billion of savings for Medicare in the first decade after they become eligible for Medicare. The editorialist asserts, however, that the data and methods used in this study do not support causal interpretations and that savings to Medicare are unlikely to be as large as suggested.

  • Leaky Pipes, Faustian Dilemmas, and a Room of One's Own: Can We Build a More Flexible Pipeline to Academic Success?

    • Amy C. Justice
    Ann Intern Med December 1, 2009 151:818-819; doi:10.1059/0003-4819-151-11-200912010-00013

    In this issue, Jagsi and associates report that men achieve R01 funding 25% to 30% more often than women. The editorialist discusses the social and cultural factors that may be contributing to this “leaky pipeline.”

On Being a Doctor

  • Take the Rabbits

    • William S. Shimp
    Ann Intern Med December 1, 2009 151:820; doi:10.1059/0003-4819-151-11-200912010-00014

  • Disparities in Medicine: An Unsettling Lesson

    • Rachel A. Winer
    Ann Intern Med December 1, 2009 151:821-822; doi:10.1059/0003-4819-151-11-200912010-00015

Letters

  • Racial Differences in Myocardial Infarction Outcomes

    • James R. Webster
    Ann Intern Med December 1, 2009 151:823; doi:10.1059/0003-4819-151-11-200912010-00017

  • Racial Differences in Myocardial Infarction Outcomes

    • Yu Han,
    • Liu Hong,
    • and Jianhua Qiu
    Ann Intern Med December 1, 2009 151:823; doi:10.1059/0003-4819-151-11-200912010-00018

  • Racial Differences in Myocardial Infarction Outcomes

    • John A. Spertus,
    • Philip G. Jones,
    • and Harlan M. Krumholz
    Ann Intern Med December 1, 2009 151:823; doi:10.1059/0003-4819-151-11-200912010-00019

  • Does Direct-to-Consumer Prescription Drug Advertising Do More Harm Than Good?

    • Agnes I. Vitry
    Ann Intern Med December 1, 2009 151:823-824; doi:10.1059/0003-4819-151-11-200912010-00020

  • Does Direct-to-Consumer Prescription Drug Advertising Do More Harm Than Good?

    • Steven Woloshin and
    • Lisa M. Schwartz
    Ann Intern Med December 1, 2009 151:824; doi:10.1059/0003-4819-151-11-200912010-00021

  • Understanding the Combined Effects of Conventional Risk Factors and Genetic Loci on Diabetes Incidence

    • Jongoh Kim
    Ann Intern Med December 1, 2009 151:824-825; doi:10.1059/0003-4819-151-11-200912010-00022

  • Understanding the Combined Effects of Conventional Risk Factors and Genetic Loci on Diabetes Incidence

    • Marilyn C. Cornelis and
    • Frank B. Hu
    Ann Intern Med December 1, 2009 151:825; doi:10.1059/0003-4819-151-11-200912010-00023

  • Ultrasonography to Guide Duration of Anticoagulation in DVT

    • Jongoh Kim
    Ann Intern Med December 1, 2009 151:825-826; doi:10.1059/0003-4819-151-11-200912010-00024

  • Ultrasonography to Guide Duration of Anticoagulation in DVT

    • Stephan Imfeld,
    • Daniel Staub,
    • Heiko Uthoff,
    • Thomas Baldi,
    • Markus Aschwanden,
    • and Kurt A. Jaeger
    Ann Intern Med December 1, 2009 151:826; doi:10.1059/0003-4819-151-11-200912010-00025

  • Ultrasonography to Guide Duration of Anticoagulation in DVT

    • Paolo Prandoni,
    • Anthonie W.A. Lensing,
    • and Martin H. Prins
    Ann Intern Med December 1, 2009 151:826-827; doi:10.1059/0003-4819-151-11-200912010-00026

  • Is Lifelong Anticoagulation Worth the Risk in Patients With Unprovoked DVT?

    • Ferdinando Cortese
    Ann Intern Med December 1, 2009 151:827; doi:10.1059/0003-4819-151-11-200912010-00027

  • Is Lifelong Anticoagulation Worth the Risk in Patients With Unprovoked DVT?

    • Samuel Z. Goldhaber
    Ann Intern Med December 1, 2009 151:827; doi:10.1059/0003-4819-151-11-200912010-00028

  • Correction: In the Clinic: Community-Acquired Pneumonia

    Ann Intern Med December 1, 2009 151:827; doi:10.1059/0003-4819-151-11-200912010-00029

Medical Writings: Book Notes

  • Beyond Anthrax

    • R. Steven Tharratt
    Ann Intern Med December 1, 2009 151:828; doi:10.1059/0003-4819-151-11-200912010-00030

  • Only 10 Seconds to Care: Help and Hope for Busy Clinicians

    • Howard S. Smith
    Ann Intern Med December 1, 2009 151:828; doi:10.1059/0003-4819-151-11-200912010-00031

Ad Libitum

  • No Clues

    • Jack Coulehan
    Ann Intern Med December 1, 2009 151:803; doi:10.1059/0003-4819-151-11-200912010-00008

  • An Elder's Mood

    • Knight Steel
    Ann Intern Med December 1, 2009 151:811; doi:10.1059/0003-4819-151-11-200912010-00010

  • Benign

    • Jack Coulehan
    Ann Intern Med December 1, 2009 151:822; doi:10.1059/0003-4819-151-11-200912010-00016

Medical Notices

  • Medical Notices

    Ann Intern Med December 1, 2009 151:0; doi:10.1059/0003-4819-151-11-200912010-00032

Summaries for Patients

  • A New Diabetes Screening Score

    Ann Intern Med December 1, 2009 151:I-27-I-28; doi:10.1059/0003-4819-151-11-200912010-00001

  • Screening for Depression in Adults: U.S. Preventive Services Task Force Recommendations

    Ann Intern Med December 1, 2009 151:I-56; doi:10.1059/0003-4819-151-11-200912010-00002

In the Clinic

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This Issue

December 1, 2009; 151 (11)
  1. Articles
  2. Academia and Clinic
  3. Perspectives
  4. Clinical Guidelines
  5. Editorials
  6. On Being a Doctor
  7. Letters
  8. Medical Writings: Book Notes
  9. Ad Libitum
  10. Medical Notices
  11. Summaries for Patients
  12. In the Clinic

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