Cover photograph by Nicola Mumoli, MD
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IN THIS ISSUE
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Patients who have perforated diverticulitis with purulent peritonitis are frequently managed surgically with open colon resection and formation of a stoma. This randomized trial assessed whether management with laparoscopic lavage alone can improve outcomes for these patients, including reducing the need for reoperations.
Up to 75% of menopausal women have hot flashes, with considerably diminished quality of life. Although women often turn to alternative therapy, such as acupuncture, for symptom relief, evidence of its efficacy for this purpose is inconsistent. This randomized, controlled trial compared the efficacy of standardized Chinese medicine acupuncture with sham acupuncture for menopausal hot flashes.
Genetic information may be used to inform persons about their risk for a specific disease. This randomized trial evaluated whether providing information on risk for an additional condition about which persons were not specifically seeking information was harmful or altered health-related behaviors.
Silicone gel breast implants, which were removed from the U.S. market in 1992 due to safety concerns, were reintroduced in 2006. This systematic review of 32 studies examines whether these implants are associated with risk for cancer, rheumatologic and autoimmune diseases, neurologic diseases, or mental health issues.
This Grand Rounds discussion highlights issues surrounding the Choosing Wisely recommendation to no longer perform periodic health examinations and summarizes a discussion between 2 internists about this recommendation as applied to an actual patient from a primary care practice.
The Advisory Committee on Immunization Practices (ACIP) presents the recommended Immunization Schedule for Adults Aged 19 Years or Older for 2016. This schedule has been approved by the ACIP, American College of Physicians, American Academy of Family Physicians, American College of Obstetricians and Gynecologists, and American College of Nurse-Midwives.
In this issue, Thornell and colleagues' trial randomly assigned patients with acute perforated diverticulitis to laparoscopic drainage and lavage or the Hartmann procedure. They found that patients who had the Hartmann procedure required surgery more often in the following 12 months than those who had lavage. The editorialists discuss these findings and note that trials comparing noninvasive management with invasive lavage and colon resection approaches are needed to define the best approach.
In this issue, Christensen and colleagues found that disclosure of unexpected genomic risk information to healthy adults did not have adverse psychological effects. The editorialist discusses the study and argues that prioritization of which genomic results to disclose to healthy patients should be based on the predictive and preventive value of the result and the costs of delivering the information.
In this issue, Balk and colleagues report a comprehensive systematic review on long-term health outcomes in women with silicone gel breast implants. The editorialists note that given the absence of solid evidence for association between silicone implants and well-defined disease, we should refocus research efforts to understand the symptoms that some women with implants report.
In this issue, Balk and colleagues perform an updated review of the long-term health outcomes of silicone gel breast implants. The editorialists discuss the importance of optimization of data collection and transparency to further research efforts in this arena as well as adherence to national and manufacturer guidelines for reporting patient events.
Annals Graphic Medicine brings together original graphic narratives, comics, animation/video, and other creative forms by those who provide or receive health care. They address medically relevant topics—whether they be poignant, thought-provoking, or just plain entertaining.