Michael K. Gould, MD, MS; Ware G. Kuschner, MD; Chara E. Rydzak, BA; Courtney C. Maclean, BA; Anita N. Demas, MD; Hidenobu Shigemitsu, MD; Jo Kay Chan, BS; Douglas K. Owens, MD, MS
Positron emission tomography with 18-fluorodeoxyglucose is more accurate than computed tomography for mediastinal staging. However, it is more sensitive but less specific when computed tomography shows enlarged mediastinal lymph nodes.
Ann Intern Med. 2003;139(11):879-892. doi:10.7326/0003-4819-139-11-200311180-00013
Lori-Ann Linkins, MD, FRCP(C); Peter T. Choi, MD, MSc, FRCP(C); James D. Douketis, MD, FRCP(C)
The authors found that anticoagulant-related major bleeding has a major impact in patients with venous thromboembolism, a factor that clinicians should take into account when deciding about long-term oral anticoagulant therapy in an individual patient.
Ann Intern Med. 2003;139(11):893-900. doi:10.7326/0003-4819-139-11-200312020-00007
Kristian Wachtell, MD, PhD; Hans Ibsen, MD; Michael H. Olsen, MD, PhD; Knut Borch-Johnsen, MD; Lars H. Lindholm, MD; Carl Erik Mogensen, MD; Bjrn Dahlf, MD, PhD; Richard B. Devereux, MD; Gareth Beevers, MD; Ulf de Faire, MD; Frej Fyhrquist, MD; Stevo Julius, MD; Sverre E. Kjeldsen, MD; Krister Kristianson, PhD; Ole Lederballe-Pedersen, MD; Markku S. Nieminen, MD; Peter M. Okin, MD; Per Omvik, MD; Suzanne Oparil, MD; Hans Wedel, PhD; Steven M. Snapinn, PhD; Peter Aurup, MD
An increased urine albumincreatinine ratio (UACR) is associated with increasing cardiovascular risk in hypertensive patients with left ventricular hypertrophy. The authors found no UACR values where risk was not affected by UACR.
Ann Intern Med. 2003;139(11):901-906. doi:10.7326/0003-4819-139-11-200312020-00008
Lisa A. Cooper, MD, MPH; Debra L. Roter, DrPH; Rachel L. Johnson, BA; Daniel E. Ford, MD, MPH; Donald M. Steinwachs, PhD; Neil R. Powe, MD, MPH, MBA
When patients and physicians are of the same race, patients are more satisfied with care in the office setting. The authors found that having the same race did not affect patient-centered communication during the office visit, eliminating it as the factor responsible for differences in patient satisfaction. Increasing ethnic diversity among physicians may be the most direct strategy to improve health care experiences for members of ethnic minority groups.
Ann Intern Med. 2003;139(11):907-915. doi:10.7326/0003-4819-139-11-200312020-00009
U.S. Preventive Services Task Force*
The U.S. Preventive Services Task Force recommends that clinicians screen all adult patients for obesity and offer intensive counseling and behavioral interventions to promote sustained weight loss for obese adults. The Task Force concludes that the evidence is insufficient to recommend for or against moderate- or low-intensity counseling or counseling in any form when coupled with behavioral interventions.
Ann Intern Med. 2003;139(11):930-932. doi:10.7326/0003-4819-139-11-200312020-00012
Kathleen M. McTigue, MD, MPH; Russell Harris, MD, MPH; Brian Hemphill, MD, MPH; Linda Lux, MPA; Sonya Sutton, BSPH; Audrina J. Bunton, BA; Kathleen N. Lohr, PhD
This systematic review describes the evidence that led the U.S. Preventive Services Task Force to its position on screening and interventions for obesity in adults.
Ann Intern Med. 2003;139(11):933-949. doi:10.7326/0003-4819-139-11-200312020-00013
Nananda F. Col, MD, MPP, MPH; Stephen G. Pauker, MD
Differences between observational and randomized studies of the effects of menopausal hormone therapy (HT) on coronary heart disease (CHD) have been attributed to the fact that women who choose to use HT tend to be healthier than those who do not. Although this bias should affect all clinical outcomes with modifiable risk factors, estimates for stroke and pulmonary embolism were unaffected. Beliefs held by patients, clinicians, and investigators might have affected the detection of CHD outcomes in observational studies.
Ann Intern Med. 2003;139(11):923-929. doi:10.7326/0003-4819-139-11-200312020-00011
Richard A. Deyo, MD, MPH; Jeffrey J. Jarvik, MD, MPH
Gould and colleagues' state-of-the-art meta-analysis on the accuracy of positron emission tomography (PET) scanning for mediastinal staging in patients with non–small-cell lung cancer supports its use. However, the effect of PET scanning on patient outcomes is unknown, which is a major shortcoming of the evidence needed to support its wider use. Improved test sensitivity and specificity alone are not enough.
Ann Intern Med. 2003;139(11):950-951. doi:10.7326/0003-4819-139-11-200312020-00014
Tom Delbanco, MD
Cooper and colleagues found that when patients and doctors were of the same race, they spent more time together during office visits and patients were more satisfied than when doctors were of a different race. These findings move us to the top of a slippery slope. Given that separate but equal should never be a goal, any move that segregates some patients and doctors from others could prove ruinous. Let's restate the question: How can we improve the way we work with our patients, no matter what our race or theirs?
Ann Intern Med. 2003;139(11):952-953. doi:10.7326/0003-4819-139-11-200312020-00015
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Edward D. Ball, MD
This year's Update in Hematology focuses on 3 exciting topics in the field: nonablative hematopoietic stem-cell transplantation, therapy targeted at specific alterations in cancer cells, and stem-cell plasticity. Groundbreaking research in the first 2 areas is changing standards of hematology care. The third area, hematopoietic stem-cell plasticity, is showing some early potential for future therapy.
Ann Intern Med. 2003;139(11):916-922. doi:10.7326/0003-4819-139-11-200312020-00010
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