Table of Contents

February 2, 2010; 152 (3)

Articles

  • Nonsteroidal Anti-inflammatory Drug Treatment for Postoperative Pericardial Effusion: A Multicenter Randomized, Double-Blind Trial

    • Philippe Meurin,
    • Jean Yves Tabet,
    • Gabriel Thabut,
    • Pascal Cristofini,
    • Titi Farrokhi,
    • Michel Fischbach,
    • Bernard Pierre,
    • Ahmed Ben Driss,
    • Nathalie Renaud,
    • Marie Christine Iliou,
    • Hélène Weber,
    • and for the French Society of Cardiology
    Ann Intern Med February 2, 2010 152:137-143; doi:10.1059/0003-4819-152-3-201002020-00004

    Meurin and colleagues assessed whether 50 mg of diclofenac twice daily for 14 days (versus placebo) would reduce pericardial effusion volume and prevent tamponade in 196 patients with moderate to large effusions more than 7 days after cardiac surgery. Similar decreases in effusion volume and similar numbers of episodes of cardiac tamponade occurred in both groups. Although small, this trial suggests that diclofenac provides little to no benefit for patients with persistent postoperative pericardial effusion.

  • Effectiveness of Extended-Duration Transdermal Nicotine Therapy: A Randomized Trial

    • Robert A. Schnoll,
    • Freda Patterson,
    • E. Paul Wileyto,
    • Daniel F. Heitjan,
    • Alexandra E. Shields,
    • David A. Asch,
    • and Caryn Lerman
    Ann Intern Med February 2, 2010 152:144-151; doi:10.1059/0003-4819-152-3-201002020-00005

    Schnoll and associates assessed whether extended-duration transdermal nicotine therapy (21 mg for 24 weeks) increased abstinence from tobacco more than standard-duration therapy (21 mg for 8 weeks) in 568 adult smokers. At week 24, rates of abstinence were higher with extended therapy than with standard therapy. Extended therapy also reduced the risk for lapse and increased the chances of recovery from lapses. At week 52, however, similar numbers of adults in both groups (about 15%) were abstinent.

  • Intravenous Immunoglobulin Treatment of the Complex Regional Pain Syndrome: A Randomized Trial

    • Andreas Goebel,
    • Andrew Baranowski,
    • Konrad Maurer,
    • Artemis Ghiai,
    • Candy McCabe,
    • and Gareth Ambler
    Ann Intern Med February 2, 2010 152:152-158; doi:10.1059/0003-4819-152-3-201002020-00006

    Preliminary data suggest that the immune system is involved in sustaining the complex regional pain syndrome (CRPS) and that low-dose intravenous immunoglobulin (IVIG) may substantially reduce pain in some patients. Goebel and coworkers found that IVIG, 0.5 g/kg, reduced the average pain intensity by 1.55 units more than saline placebo in 13 patients with refractory CRPS. In 3 patients, the pain intensity after IVIG was less than the intensity after saline by 50% or more. No serious adverse reactions were reported.

Reviews

  • Narrative Review: Fibrotic Diseases: Cellular and Molecular Mechanisms and Novel Therapies

    • Joel Rosenbloom,
    • Susan V. Castro,
    • and Sergio A. Jimenez
    Ann Intern Med February 2, 2010 152:159-166; doi:10.1059/0003-4819-152-3-201002020-00007

    In this narrative review, the authors discuss various cellular and molecular mechanisms for fibrotic diseases. Recently acquired basic knowledge about the pathogenesis of the fibrotic process has prompted the development of novel therapeutic agents capable of modifying some of the deleterious effects of the fibrotic diseases.

  • Meta-analysis: Noninvasive Coronary Angiography Using Computed Tomography Versus Magnetic Resonance Imaging

    • Georg M. Schuetz,
    • Niki Maria Zacharopoulou,
    • Peter Schlattmann,
    • and Marc Dewey
    Ann Intern Med February 2, 2010 152:167-177; doi:10.1059/0003-4819-152-3-201002020-00008

    This meta-analysis compared the effectiveness of multislice computed tomography (CT) and magnetic resonance imaging (MRI) in ruling out clinically significant coronary artery disease (CAD) in adults with suspected or known CAD. Pooled data from 89 CT studies and 20 MRI studies showed a mean respective sensitivity and specificity of 97% and 87% for CT and 87% and 70% for MRI. Respective sensitivity and specificity of CT were 98% and 89% in studies of patients with suspected CAD only.

Perspectives

  • Is Computed Tomographic Colonography Being Held to a Higher Standard?

    • Samita Garg and
    • Dennis J. Ahnen
    Ann Intern Med February 2, 2010 152:178-181; doi:10.1059/0003-4819-152-3-201002020-00009

    The authors discuss the Centers for Medicare & Medicaid Services' decision not to cover computed tomographic colonography screening. The rationale for this decision includes concerns about radiation exposure, miss rates for small polyps, detection of incidental extracolonic findings, variability in performance, and lack of evidence that adding computed tomographic colonography would increase overall screening rates. Several similar concerns, however, can be raised for other recommended and covered colon cancer screening tests.

  • Lessons That Patient-Centered Medical Homes Can Learn From the Mistakes of HMOs

    • Ann M. Mirabito and
    • Leonard L. Berry
    Ann Intern Med February 2, 2010 152:182-185; doi:10.1059/0003-4819-152-3-201002020-00011

    Many groups have endorsed the patient-centered medical home (PCMH) as an innovative structure for transforming health care delivery. The cornerstone principle of the PCMH is the primary care physician's coordination of a patient's use of health care services to improve effectiveness and efficiency. This principle aligns with the vision behind the creation of HMOs, which were once embraced by physicians, patients, and policy analysts but have since declined in popularity. This article discusses lessons that PCMHs can learn from HMOs.

Editorials

  • Asymptomatic Postoperative Pericardial Effusions: Against the Routine Use of Anti-inflammatory Drug Therapy

    • Massimo Imazio
    Ann Intern Med February 2, 2010 152:186-187; doi:10.1059/0003-4819-152-3-201002020-00012

    In this issue, Meurin and colleagues report that diclofenac did not reduce effusion size and progression to cardiac tamponade in patients with postoperative pericardial effusion lasting more than 7 days. Their study raises important issues about the management of pericardial disease, which the editorialist explores in greater detail. He concludes that until we have further data, clinicians should avoid routine use of anti-inflammatory therapies in the absence of evidence of inflammation.

  • Intravenous Immunoglobulin to Fight Complex Regional Pain Syndromes: Hopes and Doubts

    • Frank Birklein and
    • Claudia Sommer
    Ann Intern Med February 2, 2010 152:188-189; doi:10.1059/0003-4819-152-3-201002020-00013

    Patients with CRPS and their physicians enthusiastically welcome innovative and easier-to-implement treatments. In this issue, Goebel and colleagues report that IVIG, 0.5 mg/kg, reduced pain in patients with long-standing CRPS. The editorialists remind us, however, to recognize the limitations of this preliminary clinical trial and caution us to not consider CRPS as a single disease entity.

On Being a Doctor

  • Southern Hospitality

    • Kimberly D. Manning
    Ann Intern Med February 2, 2010 152:190-191; doi:10.1059/0003-4819-152-3-201002020-00014

    “I thank the Lord every day that I lost my insurance,” Mrs. Coleman said with a raspy voice. “Without y'all, I know this all would have been different. I wouldn't change a thing.” I sat in respectful silence.

  • Quite by Chance

    • Michael Stillman
    Ann Intern Med February 2, 2010 152:192-193; doi:10.1059/0003-4819-152-3-201002020-00015

    Despite our right efforts, chance imbues every patient encounter. Medicine, like life itself, is an uncertain proposition.

Letters

  • Determining the Benefits of the New York City Trans Fat Ban

    • Gilbert L. Ross
    Ann Intern Med February 2, 2010 152:194; doi:10.1059/0003-4819-152-3-201002020-00016

  • Determining the Benefits of the New York City Trans Fat Ban

    • Morton Satin
    Ann Intern Med February 2, 2010 152:194; doi:10.1059/0003-4819-152-3-201002020-00017

  • Determining the Benefits of the New York City Trans Fat Ban

    • Sonia Y. Angell,
    • Lynn Dee Silver,
    • and Gail P. Goldstein
    Ann Intern Med February 2, 2010 152:194-195; doi:10.1059/0003-4819-152-3-201002020-00018

  • Reclassification Calculations for Persons With Incomplete Follow-up

    • Ewout W. Steyerberg and
    • Michael J. Pencina
    Ann Intern Med February 2, 2010 152:195-196; doi:10.1059/0003-4819-152-3-201002020-00019

  • Reclassification Calculations for Persons With Incomplete Follow-up

    • Nancy R. Cook and
    • Paul M. Ridker
    Ann Intern Med February 2, 2010 152:196-197; doi:10.1059/0003-4819-152-3-201002020-00020

  • Stent Placement in Patients With Atherosclerotic Renal Artery Stenosis and Impaired Renal Function

    • Samuel J. Mann and
    • Thomas A. Sos
    Ann Intern Med February 2, 2010 152:197; doi:10.1059/0003-4819-152-3-201002020-00021

  • Stent Placement in Patients With Atherosclerotic Renal Artery Stenosis and Impaired Renal Function

    • Ion S. Jovin and
    • On Topaz
    Ann Intern Med February 2, 2010 152:197-198; doi:10.1059/0003-4819-152-3-201002020-00022

  • Stent Placement in Patients With Atherosclerotic Renal Artery Stenosis and Impaired Renal Function

    • Liesbeth Bax,
    • Willem P.T.M. Mali,
    • and Jaap J. Beutler
    Ann Intern Med February 2, 2010 152:198; doi:10.1059/0003-4819-152-3-201002020-00023

  • Colored Sweat Caused by Pseudochromhidrosis

    • George S. Panagoulias,
    • Christos St. Basagiannis,
    • Nicholas Tentolouris,
    • Evgenia Stavropoulou,
    • and Lazaros Karnesis
    Ann Intern Med February 2, 2010 152:198-199; doi:10.1059/0003-4819-152-3-201002020-00024

  • Correction: Screening for Breast Cancer

    Ann Intern Med February 2, 2010 152:199-200; doi:10.1059/0003-4819-152-3-201002020-00025

  • Correction: Probiotics for Ulcerative Colitis

    Ann Intern Med February 2, 2010 152:200; doi:10.1059/0003-4819-152-3-201002020-00026

Ad Libitum

  • October Fly

    • George N. Braman
    Ann Intern Med February 2, 2010 152:181; doi:10.1059/0003-4819-152-3-201002020-00010

Medical Notices

  • Medical Notices

    Ann Intern Med February 2, 2010 152:0; doi:10.1059/0003-4819-152-3-201002020-00027

Summaries for Patients

  • Treating Postoperative Pericardial Effusion With Nonsteroidal Anti-inflammatory Drug Therapy

    Ann Intern Med February 2, 2010 152:I-32; doi:10.1059/0003-4819-152-3-201002020-00001

  • Extended Nicotine Treatment for Long-Term Smokers

    Ann Intern Med February 2, 2010 152:I-38; doi:10.1059/0003-4819-152-3-201002020-00002

  • Intravenous Immunoglobulin Treatment of the Complex Regional Pain Syndrome

    Ann Intern Med February 2, 2010 152:I-48; doi:10.1059/0003-4819-152-3-201002020-00003

In the Clinic

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This Issue

February 2, 2010; 152 (3)
  1. Articles
  2. Reviews
  3. Perspectives
  4. Editorials
  5. On Being a Doctor
  6. Letters
  7. Ad Libitum
  8. Medical Notices
  9. Summaries for Patients
  10. In the Clinic

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