Eric Vittinghoff, PhD; Michael G. Shlipak, MD, MPH; Paul D. Varosy, MD; Curt D. Furberg, MD, PhD; Christine C. Ireland, MPH; Steven S. Khan, MD; Roger Blumenthal, MD; Elizabeth Barrett-Connor, MD; Stephen Hulley, MD, MPH; for the Heart and Estrogen/progestin Replacement Study Research Group
Women with coronary disease are at high risk for myocardial infarction or death from coronary heart disease even in the absence of other risk factors, and their risk increases up to sixfold when they have many risk factors. Physicians frequently fail to prescribe established drugs for secondary prevention, including aspirin, -blockers, and lipid-lowering agents, for these women at especially high risk.
Ann Intern Med. 2003;138(2):81-89. doi:10.7326/0003-4819-138-2-200301210-00007
Xianglin L. Du, MD, PhD; Charles R. Key, MD, PhD; Cynthia Osborne, MD; Jonathan D. Mahnken, MS; James S. Goodwin, MD
Actual use of chemotherapy for breast cancer differs markedly from consensus recommendations, and the gap between ideal and actual care widens for older women. Decreased use with age may reflect knowledge of clinical trials that show decreasing efficacy of chemotherapy with increasing age. Are the recommendations too aggressive, or are practicing oncologists using chemotherapy too conservatively?
Ann Intern Med. 2003;138(2):90-97. doi:10.7326/0003-4819-138-2-200301210-00009
Marcello Tonelli, MD, SM; Lemuel Moy, MD, PhD; Frank M. Sacks, MD; Bryce Kiberd, MD; Gary Curhan, MD, ScD; for the Cholesterol and Recurrent Events (CARE) Trial Investigators
Pravastatin is effective and appears safe for secondary prevention of cardiovascular events in persons with mild chronic renal insufficiency. Since statins may be underused in this setting, physicians should consider prescribing them for patients with chronic renal insufficiency and known coronary disease.
Ann Intern Med. 2003;138(2):98-104. doi:10.7326/0003-4819-138-2-200301210-00010
Xinglong Zheng, MD, PhD; Arnel M. Pallera, MD; Lawrence T. Goodnough, MD; J. Evan Sadler, MD, PhD; Morey A. Blinder, MD
Intensive immunosuppressive therapy can lead to sustained clinical remission in patients with refractory autoimmune thrombotic thrombocytopenic purpura.
Ann Intern Med. 2003;138(2):105-108. doi:10.7326/0003-4819-138-2-200301210-00011
Mark A. Crowther, MD; John G. Kelton, MD
This review summarizes current knowledge of the congenital prothrombotic states and proposes a simple classification system that divides them into two broad groups: those associated with reduced levels of the inhibitors of the coagulation cascade and those associated with increased levels or function of the coagulation factors.
Ann Intern Med. 2003;138(2):128-134. doi:10.7326/0003-4819-138-2-200301210-00014
Robert C. Moellering Jr., MD
Linezolid is the first of a new class of antimicrobial agents, the oxazolidinones, to be approved for clinical use in the United States and elsewhere. The drug is a totally synthetic compound, which lessens the likelihood of naturally occurring resistance mechanisms. It has excellent activity against almost all important gram-positive pathogens. Development of resistance to the compound has occurred infrequently thus far.
Ann Intern Med. 2003;138(2):135-142. doi:10.7326/0003-4819-138-2-200301210-00015
Joshua P. Metlay, MD, PhD; Michael J. Fine, MD, MSc
The authors review the test characteristics of the history, physical examination, and laboratory findings, individually and in combination, in diagnosing community-acquired pneumonia and predicting short-term risk for death from this condition. The knowledge base for prognostication in pneumonia is far better than the knowledge base for diagnosis.
Ann Intern Med. 2003;138(2):109-118. doi:10.7326/0003-4819-138-2-200301210-00012
Patricia Gabow, MD; Sheri Eisert, PhD; Richard Wright, MD
Urban public hospitals and community health centers share a common mission: to care for the uninsured and other vulnerable populations. In most communities, however, these two components of the safety net are administratively and clinically separate, which inhibits continuity of care and creates substantial inefficiencies. This paper describes Denver Health, a long-standing vertically and horizontally integrated system for vulnerable populations. Fully integrating public hospitals and community health centers benefits the patient and serves as a model for the U.S. safety net.
Ann Intern Med. 2003;138(2):143-149. doi:10.7326/0003-4819-138-2-200301210-00016
Andrew P. Miller, MD; Suzanne Oparil, MD
In this issue, Vittinghoff and colleagues analyze data from the Heart and Estrogen/progestin Replacement Study to identify risk factors for myocardial infarction and death from coronary heart disease and describe the participants' use of secondary prevention strategies. The most striking aspect of this analysis is the alarming underuse of proven therapies for secondary prevention of cardiovascular disease in women.
Ann Intern Med. 2003;138(2):150-151. doi:10.7326/0003-4819-138-2-200301210-00017
James N. George, MD; Sara K. Vesely, PhD
Zheng and colleagues' well-documented report of a woman whose refractory thrombotic thrombocytopenic purpura (TTP) responded to rituximab and cyclophosphamide illustrates beautifully the defining phrase of translational research, From the bench to the bedside. Is her experience representative of many patients with TTP, or is her case exceptional? How can we apply the care she received to clinical practice in the community?
Ann Intern Med. 2003;138(2):152-153. doi:10.7326/0003-4819-138-2-200301210-00018
Stephen Goldfinger, MD
The few of us who examined 2 years of correspondence before Mr. J.'s arrival at Massachusetts General Hospital were even more interested in meeting the man than in validating the exotic diagnosis we had made from his letters.
Ann Intern Med. 2003;138(2):154-155. doi:10.7326/0003-4819-138-2-200301210-00019
Ann Intern Med. 2003;138(2):156. doi:10.7326/0003-4819-138-2-200301210-00020
Ann Intern Med. 2003;138(2):156-157. doi:10.7326/0003-4819-138-2-200301210-00021
Ann Intern Med. 2003;138(2):157. doi:10.7326/0003-4819-138-2-200301210-00022
Ann Intern Med. 2003;138(2):157-158. doi:10.7326/0003-4819-138-2-200301210-00023
Ann Intern Med. 2003;138(2):158-159. doi:10.7326/0003-4819-138-2-200301210-00024
Ann Intern Med. 2003;138(2):159. doi:10.7326/0003-4819-138-2-200301210-00025
Ann Intern Med. 2003;138(2):159-160. doi:10.7326/0003-4819-138-2-200301210-00026
Ann Intern Med. 2003;138(2):160. doi:10.7326/0003-4819-138-2-200301210-00027
Bonnie Salomon, MD
Ann Intern Med. 2003;138(2):89. doi:10.7326/0003-4819-138-2-200301210-00008
Ann Intern Med. 2003;138(2):I-10. doi:10.7326/0003-4819-138-2-200301210-00001
Ann Intern Med. 2003;138(2):I-16. doi:10.7326/0003-4819-138-2-200301210-00002
Ann Intern Med. 2003;138(2):I-28. doi:10.7326/0003-4819-138-2-200301210-00003
Ann Intern Med. 2003;138(2):I-38. doi:10.7326/0003-4819-138-2-200301210-00004
Ann Intern Med. 2003;138(2):I-39. doi:10.7326/0003-4819-138-2-200301210-00005
Ann Intern Med. 2003;138(2):I-44. doi:10.7326/0003-4819-138-2-200301210-00006
Ann Intern Med. 2003;138(2):No Pagination Specified. doi:10.7326/0003-4819-138-2-200301210-00028
Karen M. Freund, MD, MPH; Nancy C. Dolan, MD; Heidi D. Nelson, MD, MPH
This Update discusses hormone replacement therapy, detection and treatment of osteoporosis, breast cancer screening, management of cervical cancer, exercise, domestic violence, urinary tract infections, and unintended pregnancy.
Ann Intern Med. 2003;138(2):119-127. doi:10.7326/0003-4819-138-2-200301210-00013
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