Issues

Barbara J. Turner, MD, MSEd; Andrea Rochat, MFA; Sarah Lill, MAM; Raudel Bobadilla, BS; Ludivina Hernandez; Aro Choi, MS; Juan A. Guerrero, MD

The advent of highly effective direct-acting antiviral therapy for hepatitis C virus (HCV) infection has led to the call for elimination of hepatitis C in the near future. The infection disproportionately affects disadvantaged communities where prevalence is high and care delivery can be particularly challenging. The current study is a mixed-methods retrospective analysis describing the design and real-world implementation of a multicomponent intervention for HCV screening and care in safety-net primary care practices.

Ann Intern Med. 2019;171(12):865-874. doi:10.7326/M18-3573

Sehoon Park, MD; Soojin Lee, MD; Yaerim Kim, MD, PhD; Yeonhee Lee, MD; Min Woo Kang, MD; Kyungdo Han, PhD; Seung Seok Han, MD, PhD; Hajeong Lee, MD, PhD; Jung Pyo Lee, MD, PhD; Kwon Wook Joo, MD, PhD; Chun Soo Lim, MD, PhD; Yon Su Kim, MD, PhD; Dong Ki Kim, MD, PhD

Metabolic syndrome has become a growing public health problem worldwide. Much effort has been devoted to the prevention and treatment of this syndrome, because affected persons have increased risk for cardiovascular disease. The objective of this population-based retrospective cohort study was to evaluate the risk for major adverse cardiovascular events among persons who develop or recover from metabolic syndrome.

Ann Intern Med. 2019;171(12):875-884. doi:10.7326/M19-0563

Andrew Conner, BS; Deborah Azrael, PhD; Matthew Miller, MD, MPH, ScD

The suicide case-fatality rate (CFR)—the proportion of suicidal acts that are fatal—depends on the distribution of methods used in the act and the probability of death given a particular method. In this cross-sectional study, the authors use data from 3 large databases for 2007 to 2014 to evaluate rates of suicide deaths and nonfatal suicide attempts, overall and method-specific CFRs, and distributions of methods used among persons aged 5 years or older.

Ann Intern Med. 2019;171(12):885-895. doi:10.7326/M19-1324

Alex Koziarz, MSc; Niv Sne, MD; Fraser Kegel, BSc; Siddharth Nath, BSc; Jetan H. Badhiwala, MD; Farshad Nassiri, MD; Alireza Mansouri, MD; Kaiyun Yang, MD; Qi Zhou, PhD; Timothy Rice, MD; Samir Faidi, MD; Edward Passos, MD; Andrew Healey, MD; Laura Banfield, MLIS; Mark Mensour, MD; Andrew W. Kirkpatrick, MD; Aussama Nassar, MD; Michael G. Fehlings, MD; Gregory W.J. Hawryluk, MD; Saleh A. Almenawer, MD

This meta-analysis of 71 studies examines the accuracy of bedside optic nerve ultrasonography for diagnosing increased intracranial pressure in persons with either traumatic or nontraumatic brain injury.

Ann Intern Med. 2019;171(12):896-905. doi:10.7326/M19-0812

Kristen E. D'Anci, PhD; Stacey Uhl, MS; Jeffrey Oristaglio, PhD; Nancy Sullivan, BA; Amy Y. Tsou, MD, MSc

This review of 19 systematic reviews and 37 randomized trials summarizes evidence about the benefits and harms of nonpharmacologic and pharmacologic treatments for motor deficits and mood disorders in adults with stroke.

Ann Intern Med. 2019;171(12):906-915. doi:10.7326/M19-2414

James Sall, PhD; Blessen C. Eapen, MD; Johanna Elizabeth Tran, MD; Amy O. Bowles, MD; Andrew Bursaw, DO; M. Eric Rodgers, PhD

This synopsis of a 2019 guideline from the U.S. Department of Veterans Affairs and U.S. Department of Defense summarizes key recommendations for rehabilitation care of patients who have suffered a stroke. Six areas, including timing and approach; motor therapy; dysphagia management; cognitive, speech, and sensory therapy; mental health therapy; and other functions, such as returning to work and driving, are addressed.

Ann Intern Med. 2019;171(12):916-924. doi:10.7326/M19-1695

Melissa B. Weimer, DO, MCR; Jeanette M. Tetrault, MD; David A. Fiellin, MD

There are ongoing efforts to lift training requirements for providers to prescribe buprenorphine for the treatment of opioid use disorder. These authors argue that such efforts, while well-meaning, are short-sighted, and that more rather than less training is needed.

Ann Intern Med. 2019;171(12):931-932. doi:10.7326/M19-2303

Albert W. Wu, MD, MPH; Victor J. Dzau, MD

Lessons learned from patient safety initiatives may be applied to reducing clinician burnout and alleviating the current crisis. Research on burnout has focused primarily on hospitals and trainees. Relatively little is known about the status of clinicians in ambulatory practice and the factors contributing to burnout in that setting. Research is needed on the most effective tools to identify burnout, as well as incentives to motivate change. Here, the authors identify 4 key lessons learned from successes in research, implementation, and policy.

Ann Intern Med. 2019;171(12):933-934. doi:10.7326/M19-2397

Jonah Tischler, BA; Katherine D. Crew, MD, MS; Wendy K. Chung, MD, PhD

Genetic testing has improved the care of women with breast cancer, informing therapeutic and preventive management decisions. As a result of increasing availability and use of genetic testing, physicians frequently need to address patients' questions and concerns about the meaning of test results. The authors explain the importance of somatic and germline mutation analyses and their implications for patients and their families.

Ann Intern Med. 2019;171(12):925-930. doi:10.7326/M18-2417

Kathleen Y. Ogle, MD; Resa E. Lewiss, MD

In their systematic review, Koziarz and colleagues examine optic nerve ultrasonography for diagnosing increased intracranial pressure in children and adults. The editorialists encourage cautious interpretation of the findings because measurement of the optic nerve sheath diameter is more challenging than other bedside ultrasonography clinical applications.

Ann Intern Med. 2019;171(12):935-936. doi:10.7326/M19-2928

Serena Auñón-Chancellor, MD, MPH

NASA pulls from several professions for the astronaut corps. On my crew, we had geophysicists; a military test pilot; a teacher; and me, an internist.

Ann Intern Med. 2019;171(12):937-938. doi:10.7326/M19-2759

Sharon Ostfeld-Johns, MD

Taking responsibility for this patient, the right amount, was the right thing.

Ann Intern Med. 2019;171(12):939. doi:10.7326/M19-0356

Ann Intern Med. 2019;171(12):940-941. doi:10.7326/L19-0369

Ann Intern Med. 2019;171(12):941-943. doi:10.7326/L19-0323

Ann Intern Med. 2019;171(12):943-944. doi:10.7326/L19-0670

Ann Intern Med. 2019;171(12):944. doi:10.7326/L19-0669

Ann Intern Med. 2019;171(12):944-945. doi:10.7326/L19-0671

D.A. Frater, MD

Ann Intern Med. 2019;171(12):945. doi:10.7326/M19-0931

D.A. Frater, MD

Ann Intern Med. 2019;171(12):946. doi:10.7326/M19-0930

Ann Intern Med. 2019;171(12):947-956. doi:10.7326/M19-8000

Ann Intern Med. 2019;171(12):JC62. doi:10.7326/ACPJ201912170-062

Ann Intern Med. 2019;171(12):JC63. doi:10.7326/ACPJ201912170-063

Ann Intern Med. 2019;171(12):JC64. doi:10.7326/ACPJ201912170-064

Ann Intern Med. 2019;171(12):JC65. doi:10.7326/ACPJ201912170-065

Ann Intern Med. 2019;171(12):JC66. doi:10.7326/ACPJ201912170-066

Ann Intern Med. 2019;171(12):JC67. doi:10.7326/ACPJ201912170-067

Ann Intern Med. 2019;171(12):JC68. doi:10.7326/ACPJ201912170-068

Ann Intern Med. 2019;171(12):JC69. doi:10.7326/ACPJ201912170-069

Ann Intern Med. 2019;171(12):JC70. doi:10.7326/ACPJ201912170-070

Ann Intern Med. 2019;171(12):JC71. doi:10.7326/ACPJ201912170-071

Geno J. Merli, MD; Howard H. Weitz, MD

Annals Consult Guys brings a new perspective to the art and science of medicine with lively discussion and analysis of real-world cases and situations. They address medically relevant topics—whether they be poignant, thought-provoking, or just plain entertaining.

Ann Intern Med. 2019;171(12):CG1. doi:10.7326/W18-0051

Darren B. Taichman, MD, PhD

Ann Intern Med. 2019;171(12):ED12. doi:10.7326/AWED201912170

David H. Wesorick, MD; Vineet Chopra, MD, MSc

Ann Intern Med. 2019;171(12):HO1. doi:10.7326/AWHO201912170

Isaac Ghinai, MBBS, MSc; Jennifer E. Layden, MD, PhD

This commentary provides clinical pearls for hospital medicine physicians caring for patients who present with symptoms that might indicate vaping-related lung injury.

Ann Intern Med. 2019;171(12):HO2-HO3. doi:10.7326/M19-3574

Robert M. Centor, MD; Lisa H.Y. Kim, MD

In this episode of Annals On Call, Dr. Centor discusses the use of supplemental oxygen in hospitalized patients with Dr. Lisa Kim.

Ann Intern Med. 2019;171(12):OC1. doi:10.7326/A19-0020

Michael Natter, MD

Progress Notes explores the everyday emotional, clinical, humorous, and ethical challenges of the medical residency training process. It appears monthly in Annals Graphic Medicine at Annals.org.

Ann Intern Med. 2019;171(12):W79-W80. doi:10.7326/G19-0072

Stefan Tigges, MD

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.

Ann Intern Med. 2019;171(12):W81-W85. doi:10.7326/G19-0011

Ann Intern Med. 2019;171(12):I-20. doi:10.7326/P19-0016