Table of Contents

October 20, 2009; 151 (8)

Articles

  • Effect of Fluticasone With and Without Salmeterol on Pulmonary Outcomes in Chronic Obstructive Pulmonary Disease: A Randomized Trial

    • Thérèse S. Lapperre,
    • Jiska B. Snoeck-Stroband,
    • Margot M.E. Gosman,
    • Désirée F. Jansen,
    • Annemarie van Schadewijk,
    • Henk A. Thiadens,
    • Judith M. Vonk,
    • H. Marike Boezen,
    • Nick H.T. ten Hacken,
    • Jacob K. Sont,
    • Klaus F. Rabe,
    • Huib A.M. Kerstjens,
    • Pieter S. Hiemstra,
    • Wim Timens,
    • Dirkje S. Postma,
    • Peter J. Sterk,
    • and the GLUCOLD (Groningen Leiden Universities Corticosteroids in Obstructive Lung Disease) Study Group
    Ann Intern Med October 20, 2009 151:517-527; doi:10.1059/0003-4819-151-8-200910200-00004

    Inhaled corticosteroids and long-acting β2-agonists improve chronic obstructive pulmonary disease (COPD) symptoms, but their effects on lung function and inflammation are uncertain. Lapperre and colleagues compared treatment with fluticasone for 6 months or 30 months, fluticasone and salmeterol for 30 months, or placebo in 114 steroid-naive patients who had moderate to severe COPD. They found reduced inflammatory cells in sputum and bronchial biopsies and an attenuated decrease in lung function during fluticasone treatment. Adding salmeterol did not further alter the decrease in lung function.

  • Collaborative Meta-analysis: Associations of 150 Candidate Genes With Osteoporosis and Osteoporotic Fracture

    • J. Brent Richards,
    • Fotini K. Kavvoura,
    • Fernando Rivadeneira,
    • Unnur Styrkársdóttir,
    • Karol Estrada,
    • Bjarni V. Halldórsson,
    • Yi-Hsiang Hsu,
    • M. Carola Zillikens,
    • Scott G. Wilson,
    • Benjamin H. Mullin,
    • Najaf Amin,
    • Yurii S. Aulchenko,
    • L. Adrienne Cupples,
    • Panagiotis Deloukas,
    • Serkalem Demissie,
    • Albert Hofman,
    • Augustine Kong,
    • David Karasik,
    • Joyce B. van Meurs,
    • Ben A. Oostra,
    • Huibert A.P. Pols,
    • Gunnar Sigurdsson,
    • Unnur Thorsteinsdottir,
    • Nicole Soranzo,
    • Frances M.K. Williams,
    • Yanhua Zhou,
    • Stuart H. Ralston,
    • Gudmar Thorleifsson,
    • Cornelia M. van Duijn,
    • Douglas P. Kiel,
    • Kari Stefansson,
    • André G. Uitterlinden,
    • John P.A. Ioannidis,
    • Tim D. Spector,
    • and for the GEFOS (Genetic Factors for Osteoporosis) Consortium
    Ann Intern Med October 20, 2009 151:528-537; doi:10.1059/0003-4819-151-8-200910200-00006

    Although variations in 150 genes have been tested for their influence on bone mineral density (BMD), they have not been tested for replication in large studies that assess all common genetic variation among these genes. In this analysis of genome-wide association results from 5 large European populations, variations in only 9 of 150 genes were associated with BMD and variations in only 4 genes were associated with fractures related to low BMD.

  • Cost-Effectiveness of Human Papillomavirus Vaccination and Cervical Cancer Screening in Women Older Than 30 Years in the United States

    • Jane J. Kim,
    • Jesse Ortendahl,
    • and Sue J. Goldie
    Ann Intern Med October 20, 2009 151:538-545; doi:10.1059/0003-4819-151-8-200910200-00007

    Kim and associates modeled the cost-effectiveness of human papillomavirus (HPV) vaccination for women aged 35 to 45 years. Vaccination ranged from $116 950 to $381 590 per quality-adjusted life-year gained across various assumptions about how clinicians would screen for cervical cancer and HPV infection in addition to vaccination. The potential benefits of HPV vaccination for women in this age group who are screened seems, on average, to be small.

Improving Patient Care

  • Risk for Hospital Contact With Infection in Patients With Splenectomy: A Population-Based Cohort Study

    • Reimar W. Thomsen,
    • W. Marieke Schoonen,
    • Dóra K. Farkas,
    • Anders Riis,
    • Jacob Jacobsen,
    • Jon P. Fryzek,
    • and Henrik Toft Sørensen
    Ann Intern Med October 20, 2009 151:546-555; doi:10.1059/0003-4819-151-8-200910200-00008

    Investigators compared the risk for infections that required hospital care in all 3812 patients in Denmark who underwent splenectomy from 1996 to 2005 with that in 3 groups: the general population, appendectomized patients, and unsplenectomized patients with conditions that could lead to splenectomy. Infection risk was highest in the 90 days after splenectomy. Risk was 4.6 times higher in splenectomized patients than in the general population but was only modestly higher than that in unsplenectomized patients who had conditions that can lead to splenectomy.

Reviews

  • Systematic Review: Charged-Particle Radiation Therapy for Cancer

    • Teruhiko Terasawa,
    • Tomas Dvorak,
    • Stanley Ip,
    • Gowri Raman,
    • Joseph Lau,
    • and Thomas A. Trikalinos
    Ann Intern Med October 20, 2009 151:556-565; doi:10.1059/0003-4819-151-8-200910200-00145

    Charged-particle radiation therapy is an alternative mode of radiation delivery for patients with cancer. This review found that published evidence about the benefits and harms of this therapy were derived mostly from small, single-group, retrospective studies. Of the 17 studies that compared treatments with or without charged particles, none reported statistically significant or important differences in overall or cancer-specific survival or in total serious adverse events.

  • Meta-analysis: Ventilation Strategies and Outcomes of the Acute Respiratory Distress Syndrome and Acute Lung Injury

    • Christian Putensen,
    • Nils Theuerkauf,
    • Jörg Zinserling,
    • Hermann Wrigge,
    • and Paolo Pelosi
    Ann Intern Med October 20, 2009 151:566-576; doi:10.1059/0003-4819-151-8-200910200-00011

    Ventilation strategies to protect the lungs of patients with the acute respiratory distress syndrome (ARDS) include low tidal volume, limited airway pressures, and medium to high positive end-expiratory pressure (PEEP). This review of evidence for low tidal volume and high PEEP ventilation on mortality of patients with ARDS found that the few published trials showed mortality benefits with lower versus higher tidal volume. High PEEP did not improve mortality in unselected patients but may help patients with life-threatening hypoxemia despite other interventions.

Perspectives

  • Medicine as Ecoculture

    • Muriel R. Gillick
    Ann Intern Med October 20, 2009 151:577-580; doi:10.1059/0003-4819-151-8-200910200-00012

    Gillick provides an explanatory model of the health care system, drawn on an analogy with the ecosystem, to help understand why new technology is introduced in particular regions and how physicians come to use the new technology. She discusses how effective health care reform needs to consider the medical ecoculture by stimulating change at multiple levels, including the organization of physician practice, regulation, and device manufacturers, as well as reimbursement.

Editorials

  • Identification of Osteoporosis Risk Genes: The Tip of the Iceberg

    • Joseph M. Zmuda
    Ann Intern Med October 20, 2009 151:581-582; doi:10.1059/0003-4819-151-8-200910200-00013

    In this issue, Richards and colleagues report an analysis of 36 000 single-nucleotide polymorphisms (SNPs) within 50 kilobase pairs of 150 genes investigated in at least 1 prior study for association with osteoporosis. They found that SNPs in most of the genes were not statistically significantly associated with BMD or fracture. Their work is an important step toward gaining a better understanding of the genetic causes of osteoporosis.

  • Randomized Trials and Technology Assessment

    • Joel E. Tepper and
    • A. William Blackstock
    Ann Intern Med October 20, 2009 151:583-584; doi:10.1059/0003-4819-151-8-200910200-00146

    There is relatively little consensus on how best to evaluate new medical technology for clinical use. Terasawa and colleagues' comparative effectiveness review in this issue demonstrates the lack of good phase 3 studies evaluating proton-beam therapies. We must address important definitional, financial, and technical issues if the evaluation of radiation therapy and the general field of technology assessment is to move forward.

On Being a Patient

  • Lovenox Hurts

    • Samantha M. Jaglowski
    Ann Intern Med October 20, 2009 151:585-586; doi:10.1059/0003-4819-151-8-200910200-00015

Letters

  • Responses to USPSTF Guideline on Aspirin for Prevention of Cardiovascular Disease

    • Vikram Budhraja
    Ann Intern Med October 20, 2009 151:587; doi:10.1059/0003-4819-151-8-200910200-00017

  • Responses to USPSTF Guideline on Aspirin for Prevention of Cardiovascular Disease

    • Arun V. Mohan,
    • Carmen Patrick Mohan,
    • and Richard Balaban
    Ann Intern Med October 20, 2009 151:587-588; doi:10.1059/0003-4819-151-8-200910200-00018

  • Responses to USPSTF Guideline on Aspirin for Prevention of Cardiovascular Disease

    • Ned Calonge,
    • Diana Petitti,
    • and Mary Barton
    Ann Intern Med October 20, 2009 151:588; doi:10.1059/0003-4819-151-8-200910200-00019

  • Missed Opportunities in the Trial on Proton-Pump Inhibitor Therapy in Bleeding Peptic Ulcers

    • Vivian Yih and
    • Aaron Tejani
    Ann Intern Med October 20, 2009 151:588-589; doi:10.1059/0003-4819-151-8-200910200-00020

  • Missed Opportunities in the Trial on Proton-Pump Inhibitor Therapy in Bleeding Peptic Ulcers

    • Hwai-Jeng Lin and
    • Yao-Chun Hsu
    Ann Intern Med October 20, 2009 151:589; doi:10.1059/0003-4819-151-8-200910200-00021

  • Missed Opportunities in the Trial on Proton-Pump Inhibitor Therapy in Bleeding Peptic Ulcers

    • Alejandro Piscoya
    Ann Intern Med October 20, 2009 151:589-590; doi:10.1059/0003-4819-151-8-200910200-00022

  • Missed Opportunities in the Trial on Proton-Pump Inhibitor Therapy in Bleeding Peptic Ulcers

    • Joseph J.Y. Sung,
    • Alan Barkun,
    • and Ernst J. Kuipers
    Ann Intern Med October 20, 2009 151:590; doi:10.1059/0003-4819-151-8-200910200-00023

  • Universal Insurance Coverage and Health Care Inequity

    • Zhiping Yang,
    • Qiong Wu,
    • and Daiming Fan
    Ann Intern Med October 20, 2009 151:590-591; doi:10.1059/0003-4819-151-8-200910200-00024

  • Inappropriate Diagnosis and Chelation Treatment of Alleged Heavy-Metal Toxicity

    • Robert S. Baratz and
    • Stephen Barrett
    Ann Intern Med October 20, 2009 151:591; doi:10.1059/0003-4819-151-8-200910200-00025

  • Correction: Effects of a Mediterranean-Style Diet on the Need for Antihyperglycemic Drug Therapy in Patients With Newly Diagnosed Type 2 Diabetes

    Ann Intern Med October 20, 2009 151:591; doi:10.1059/0003-4819-151-8-200910200-00026

Medical Writings: Book Notes

  • Future of Bioethics

    • Arnold R. Eiser
    Ann Intern Med October 20, 2009 151:592; doi:10.1059/0003-4819-151-8-200910200-00027

  • The Practice of International Health: A Case-Based Orientation

    • Frank J. Bia
    Ann Intern Med October 20, 2009 151:592; doi:10.1059/0003-4819-151-8-200910200-00028

Ad Libitum

  • The Doctor Will See You

    • Henry S. Kahn
    Ann Intern Med October 20, 2009 151:527; doi:10.1059/0003-4819-151-8-200910200-00005

  • Oracle Bones

    • Richard Donze
    Ann Intern Med October 20, 2009 151:565; doi:10.1059/0003-4819-151-8-200910200-00010

  • Prison Break

    • George N. Braman
    Ann Intern Med October 20, 2009 151:586; doi:10.1059/0003-4819-151-8-200910200-00016

Medical Notices

  • Medical Notices

    Ann Intern Med October 20, 2009 151:0; doi:10.1059/0003-4819-151-8-200910200-00029

Summaries for Patients

  • Effect of Treatment With Fluticasone With and Without Salmeterol on Airway Inflammation and Lung Function in Patients With Chronic Obstructive Pulmonary Disease

    Ann Intern Med October 20, 2009 151:I-21; doi:10.1059/0003-4819-151-8-200910200-00001

  • Cost-Effectiveness of Human Papillomavirus Vaccination and Cervical Cancer Screening in Women Older Than 30 Years in the United States

    Ann Intern Med October 20, 2009 151:I-36; doi:10.1059/0003-4819-151-8-200910200-00002

  • Risk for Hospitalization for Infection in Patients Who Have Had Splenectomy

    Ann Intern Med October 20, 2009 151:I-42; doi:10.1059/0003-4819-151-8-200910200-00003

ACP Journal Club

  • Editorial: Stratification for exploring heterogeneity in systematic reviews

    Ann Intern Med October 20, 2009 151:JC4-2; doi:10.1059/0003-4819-151-8-200910200-02002

  • Review: Preoperative smoking cessation interventions reduce postoperative complications

    Ann Intern Med October 20, 2009 151:JC4-4; doi:10.1059/0003-4819-151-8-200910200-02004

  • Adding prompt revascularization to medical therapy did not reduce mortality or CV events in patients with type 2 diabetes and CAD

    Ann Intern Med October 20, 2009 151:JC4-5; doi:10.1059/0003-4819-151-8-200910200-02005

  • Minimally invasive and conventional glucose monitoring did not differ for long-term glycemic control in insulin-treated diabetes

    Ann Intern Med October 20, 2009 151:JC4-6; doi:10.1059/0003-4819-151-8-200910200-02006

  • Rosiglitazone was noninferior to metformin plus sulfonylurea for CV events but increased risk for HF and fractures in type 2 diabetes

    Ann Intern Med October 20, 2009 151:JC4-8; doi:10.1059/0003-4819-151-8-200910200-02008

  • Graduated compression stockings did not prevent deep venous thrombosis after stroke and increased skin complications

    Ann Intern Med October 20, 2009 151:JC4-9; doi:10.1059/0003-4819-151-8-200910200-02009

  • Review: Evidence for the effectiveness of nonsurgical interventions for low back pain and radiculopathy is limited

    Ann Intern Med October 20, 2009 151:JC4-10; doi:10.1059/0003-4819-151-8-200910200-02010

  • Review: Evidence for the effectiveness of surgery for low back pain, radiculopathy, and spinal stenosis is limited

    Ann Intern Med October 20, 2009 151:JC4-11; doi:10.1059/0003-4819-151-8-200910200-02011

  • Quadrivalent HPV vaccine reduced risk for HPV infection and related disease in women 24 to 45 years of age

    Ann Intern Med October 20, 2009 151:JC4-12; doi:10.1059/0003-4819-151-8-200910200-02012

  • Review: Amiodarone reduces risk for sudden cardiac death but not all-cause mortality in cardiomyopathy

    Ann Intern Med October 20, 2009 151:JC4-13; doi:10.1059/0003-4819-151-8-200910200-02013

  • Review: Statins reduce mortality and cardiovascular events in adults at risk for cardiovascular disease

    Ann Intern Med October 20, 2009 151:JC4-14; doi:10.1059/0003-4819-151-8-200910200-02014

  • Contrast-enhanced magnetic resonance angiography is the most accurate noninvasive imaging technique for carotid stenosis

    Ann Intern Med October 20, 2009 151:JC4-15; doi:10.1059/0003-4819-151-8-200910200-02015

  • Glossary

    Ann Intern Med October 20, 2009 151:JC4-16; doi:10.1059/0003-4819-151-8-200910200-02016
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This Issue

October 20, 2009; 151 (8)
  1. Articles
  2. Improving Patient Care
  3. Reviews
  4. Perspectives
  5. Editorials
  6. On Being a Patient
  7. Letters
  8. Medical Writings: Book Notes
  9. Ad Libitum
  10. Medical Notices
  11. Summaries for Patients
  12. ACP Journal Club

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