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William S. Yancy Jr., MD; Stephanie B. Mayer, MD; Cynthia J. Coffman, PhD; Valerie A. Smith, DrPH; Ronette L. Kolotkin, PhD; Paula J. Geiselman, PhD; Megan A. McVay, PhD; Eugene Z. Oddone, MD; and Corrine I. Voils, PhD

Studies have suggested that allowing choice among diets improves weight outcomes. This double-randomized preference trial evaluated whether participants who were given a choice between 2 diets would have greater weight loss than those randomly assigned to a diet. Offering diet choice did not improve weight loss, dietary adherence, or weight-related quality of life.

Topics: weight reduction, diet
Edgar Turner Overton, MD; Ellen S. Chan, MSc; Todd T. Brown, MD, PhD; Pablo Tebas, MD; Grace A. McComsey, MD; Kathleen M. Melbourne, PharmD; Andrew Napoli, PhD; William Royce Hardin, BS; Heather J. Ribaudo, PhD; and Michael T. Yin, MD, MS

Initiation of antiretroviral therapy (ART) for HIV-1 infection is associated with a loss in bone mineral density (BMD) of 2% to 6%. This randomized trial evaluated the effect of vitamin D3 plus calcium supplementation on bone loss associated with ART initiation. The authors found that supplementation mitigated BMD loss.

Topics: vitamin d, osteopenia, anti-retroviral agents, hiv, calcium, cholecalciferol, attenuation
Becky A. Briesacher, PhD; Jeanne M. Madden, PhD; Fang Zhang, PhD; Hassan Fouayzi, MS; Dennis Ross-Degnan, ScD; Jerry H. Gurwitz, MD; and Stephen B. Soumerai, ScD

Although Medicare Part D has increased access to drugs, how it has affected health outcomes is unclear. This time-series analysis used data from the Medicare Current Beneficiary Survey from 2000 to 2010 and studied outcomes 5 years after plan implementation. Contrary to previous reports, the authors found no evidence of Part D's effect on various population-level health indicators among Medicare enrollees.

Topics: hospitalization, medicare, health outcomes, medicare part d, trend, inpatient, emergency service, hospital, ...
Elizabeth Haney, MD; M.E. Beth Smith, DO; Marian McDonagh, PharmD; Miranda Pappas, MA; Monica Daeges, BA; Ngoc Wasson, MPH; and Heidi D. Nelson, MD, MPH
Includes: CME

Diagnosis of myalgic encephalomyelitis (ME)/chronic fatigue syndrome (CFS) is based on clinical criteria, but there has not been consensus regarding which set of criteria best identifies patients with the condition. This systematic review on ME/CFS for the National Institutes of Health (NIH) 2014 Pathways to Prevention Workshop evaluated and compared studies of methods to diagnose ME/CFS and identified limitations of current studies and needs for future research.

Topics: chronic fatigue syndrome, united states national institutes of health, fatigue
M.E. Beth Smith, DO; Elizabeth Haney, MD; Marian McDonagh, PharmD; Miranda Pappas, MA; Monica Daeges, BA; Ngoc Wasson, MPH; Rongwei Fu, PhD; and Heidi D. Nelson, MD, MPH
Includes: CME

A debilitating multisystem condition, ME/CFS is characterized by chronic and disabling fatigue and several other symptoms. This systematic review, part of a larger report for the NIH 2014 Pathways to Prevention Workshop, evaluated research on the benefits and harms of medical and nonmedical treatments for ME/CFS, as well as identified limitations of current studies and needs for future research in this area.

Topics: chronic fatigue syndrome, fatigue, complementary therapies, counseling, united states national institutes of ...
George F. Sawaya, MD; Shalini Kulasingam, PhD; Thomas D. Denberg, MD, PhD; Amir Qaseem, MD, PhD, MHA, for the Clinical Guidelines Committee of the American College of Physicians

In this best practice advice article, the Clinical Guidelines Committee of the American College of Physicians describes the indications for screening for cervical cancer in asymptomatic, average-risk women aged 21 years or older.

Topics: cervical cancer screening, best practice, american college of physicians

This paper summarizes findings of an NIH Pathways to Prevention Workshop about ME/CFS that was cosponsored by the NIH Office of Disease Prevention and the Trans-NIH Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Research Working Group. Specific purposes of the workshop included identifying pressing research gaps, assessing methodological weaknesses of available evidence, and formulating future research recommendations.

Topics: chronic fatigue syndrome, united states national institutes of health

This commentary discusses the paradoxical finding that most patients are at below-average risk and can expect to experience less-than-average benefits from a treatment. This “Lake Wobegon effect,” the authors argue, can result in too many patients being screened, diagnosed, and treated.

Topics: therapeutics, lung cancer, overtreatment, smoking

Cervical cancer screening is the topic of this issue's discussion from the Annals archive.

Topics: cervical cancer screening

In this issue, Briesacher and colleagues' study found no evidence of Medicare Part D's effect (5 years after plan implementation) on various population-level health indicators among Medicare enrollees. The editorialist reviews these results and asserts why they should be interpreted with caution.

Topics: drug benefit plan, medicare part d, medicare

No diagnostic tests or proven treatments are available for ME/CFS. The condition has recently received some welcome attention from the Institute of Medicine, Agency for Healthcare Research and Quality, and NIH. Four recent Annals articles address their findings, and this editorial recaps answers to important questions.

Topics: chronic fatigue syndrome, institute of medicine (u.s.)
Daniela Lamas, MD
Includes: Audio/Video

The way I remember it now, I spent much of my medical internship doing things to people—uncomfortable, even unnecessary things—at odd hours to seem thorough on rounds.

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Anna Calzi, MD; Francesca Bisio, MD, PhD; and Daniele Roberto Giacobbe, MD
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Ingrid T. Katz, MD, MHS; David E. Shapiro, PhD; and Ruth Tuomala, MD
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Seigo Urushidani, MD; and Akira Kuriyama, MD, MPH
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Aviroop Biswas, BSc; and David A. Alter, MD, PhD
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Jan Matthys, MD; Marc De Meyere, MD; and An De Sutter, MD
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James R. Uhl, MS; Daniel R. Gustafson, BS; Stefanea L. Rucinski, MT (ASCP); and Robin Patel, MD
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Robert M. Centor, MD; T. Prescott Atkinson, MD, PhD; and Ken B. Waites, MD
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Robert M. Centor, MD; T. Prescott Atkinson, MD; Carlos Estrada, MD; and Ken B. Waites, MD
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Pieter A. Cohen, MD; Rickard Zeijlon, MD; Rachel Nardin, MD; Peter H.J. Keizers, PhD; and Bastiaan Venhuis, PhD
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Topics: percutaneous coronary intervention, st-segment elevation mi, cerebrovascular accident, ischemic stroke, thrombectomy, follow-up ...
Topics: dementia, agitation
Topics: chronic obstructive airway disease, exercise tolerance, quality of life, pulmonary rehabilitation
Topics: asthma, long-acting inhaled beta-agonist, tiotropium, pulmonary function
Topics: renal failure, acute, inpatient, follow-up
Topics: diabetic retinopathy, blood pressure regulation, diabetes mellitus, type 2
Topics: multiple sclerosis, vaccines, tetanus, fingolimod, influenza, immune response, follow-up
Topics: rheumatoid arthritis, methotrexate, treatment outcome, rituximab
Topics: open-angle glaucoma, visual fields, latanoprost, follow-up
Topics: stents, vascular, coronary, perioperative myocardial infarction, mortality, cardiac event
Topics: pancreatitis, acute, incretin
Topics: spironolactone, death, sudden, trimethoprim-sulfamethoxazole combination, elderly

The Consult Guys bring a new perspective to the art and science of medicine with lively discussion and analysis of real-world cases and situations.

Topics: hypertension, consultation, killing
Topics: weight reduction, diet
Topics: cervical cancer screening
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