Louise C. Walter, MD; Karla Lindquist, MS; Kenneth E. Covinsky, MD, MPH
Rates of screening mammography and Papanicolaou smears are high among older women in California. Although screening rates decline with advancing age, women of a similar age have similar screening rates whether they say that they are in good health or poor health. Physicians should target their screening efforts at healthy older women, in whom the benefits of screening are likely to outweigh potential harms.
Ann Intern Med. 2004;140(9):681-688. doi:10.7326/0003-4819-140-9-200405040-00007
Thomas J. Hoerger, PhD; Russell Harris, MD, MPH; Katherine A. Hicks, MS; Katrina Donahue, MD, MPH; Stephen Sorensen, PhD; Michael Engelgau, MD
Diabetes screening targeted to people with hypertension is more cost-effective than universal screening. The most cost-effective strategy is to screen people at age 55 to 75 years because hypertension is more common and cardiovascular death rates are higher in older people.
Ann Intern Med. 2004;140(9):689-699. doi:10.7326/0003-4819-140-9-200405040-00008
Manuel J. Quiñones, MD; Miguel Hernandez-Pampaloni, MD, PhD; Heinrich Schelbert, MD, PhD; Isabel Bulnes-Enriquez, MD; Xochitl Jimenez, MD; Gustavo Hernandez, MD; Roxana De La Rosa, BS; Yun Chon, PhD; Huiying Yang, MD, PhD; Susanne B. Nicholas, MD, PhD; Tamara Modilevsky, MD; Katherine Yu, MD; Katja Van Herle, MD; Lawrence W. Castellani, PhD; Robert Elashoff, PhD; Willa A. Hsueh, MD
Insulin-resistant patients experience a smaller increase in coronary blood flow by endothelium-dependent mechanisms than do insulin-sensitive patients. Thiazolidinedione therapy, which increases insulin sensitivity, normalized the abnormalities in insulin-resistant individuals. Insulin resistance may be associated with abnormalities in coronary vasomotor function.
Ann Intern Med. 2004;140(9):700-708. doi:10.7326/0003-4819-140-9-200405040-00009
Luca Richeldi, MD, PhD; Katie Ewer, BSc; Monica Losi, BSc; David M. Hansell, MD; Pietro Roversi, MD; Leonardo M. Fabbri, MD; Ajit Lalvani, MRCP, DM
An enzyme-linked immunospot assay detects T cells that are specific for Mycobacterium tuberculosis–specific antigens. A positive result on this test helped diagnose subclinical active tuberculosis in an immunosuppressed patient with a false-negative tuberculin skin test result.
Ann Intern Med. 2004;140(9):709-713. doi:10.7326/0003-4819-140-9-200405040-00010
Takahiro Higashi, MD; Paul G. Shekelle, MD, PhD; David H. Solomon, MD; Eric L. Knight, MD, MPH; Carol Roth, RN, MPH; John T. Chang, MD, MPH; Caren J. Kamberg, MSPH; Catherine H. MacLean, MD, PhD; Roy T. Young, MD; John Adams, PhD; David B. Reuben, MD; Jerry Avorn, MD; Neil S. Wenger, MD, MPH
In older patients, failures to prescribe indicated medications, monitor medications appropriately, document necessary information, educate patients, and maintain continuity are more common prescribing problems than is use of inappropriate drugs.
Ann Intern Med. 2004;140(9):714-720. doi:10.7326/0003-4819-140-9-200405040-00011
Michael S. Lee, MD; Raj R. Makkar, MD
In principle, stem cells could rapidly regenerate contracting myocardium and improve immediate and long-term prognosis after acute myocardial infarction. This article describes the formidable obstacles to achieving this goal.
Ann Intern Med. 2004;140(9):729-737. doi:10.7326/0003-4819-140-9-200405040-00013
U.S. Preventive Services Task Force*
The U.S. Preventive Services Task Force concludes that the evidence is insufficient to recommend for or against screening asymptomatic persons for lung cancer with low-dose computed tomography, chest x-ray, sputum cytology, or a combination of these tests.
Ann Intern Med. 2004;140(9):738-739. doi:10.7326/0003-4819-140-9-200405040-00014
Linda L. Humphrey, MD, MPH; Steven Teutsch, MD, MPH; Mark Johnson, MD, MPH
Current data do not show that screening for lung cancer is effective with any method. The evidence, however, is not strong enough to conclude that screening is ineffective, particularly in women. Two ongoing randomized trials of screening with chest radiography or low-dose computed tomography should help clinicians to decide whether lung cancer screening is worthwhile.
Ann Intern Med. 2004;140(9):740-753. doi:10.7326/0003-4819-140-9-200405040-00015
Angela Fagerlin, PhD; David Rovner, MD; Sue Stableford, MPH, MSB; Christophir Jentoft, BA; John T. Wei, MD; Margaret Holmes-Rovner, PhD
Most patient education materials on early-stage prostate cancer treatment do not contain comprehensive information about the risks and benefits of each treatment alternative. To help patients and physicians choose among prostate cancer treatment options, we need a new generation of patient education materials.
Ann Intern Med. 2004;140(9):721-728. doi:10.7326/0003-4819-140-9-200405040-00012
H. Gilbert Welch, MD, MPH
Readers can be confident that a substantial proportion of elderly women should undergo regular cervical and breast cancer screening. Now the tougher question: Are we screening these women for the right reason?
Ann Intern Med. 2004;140(9):754-755. doi:10.7326/0003-4819-140-9-200405040-00016
David M. Nathan, MD; William H. Herman, MD, MPH
Hoerger and colleagues have used decision modeling to advance our understanding of the benefit of screening for diabetes in people with and without hypertension. However, without optimized management of hypertension and hyperglycemia after the diagnosis of diabetes, no screening program can be effective or cost-effective.
Ann Intern Med. 2004;140(9):756-758. doi:10.7326/0003-4819-140-9-200405040-00017
Howard Fillit, MD
As an expert witness for the defense, I reviewed the case of a 90-year-old woman with Alzheimer disease who died of complications from a urinary tract infection in a nursing home. The case seemed like a typical clinical situation I had been involved with many times as a geriatrician, but in this case, the doctor was being sued for wrongful death.
Ann Intern Med. 2004;140(9):759-760. doi:10.7326/0003-4819-140-9-200405040-00018
Ann Intern Med. 2004;140(9):761. doi:10.7326/0003-4819-140-9-200405040-00019
Ann Intern Med. 2004;140(9):761-762. doi:10.7326/0003-4819-140-9-200405040-00020
Ann Intern Med. 2004;140(9):762. doi:10.7326/0003-4819-140-9-200405040-00021
Ann Intern Med. 2004;140(9):763. doi:10.7326/0003-4819-140-9-200405040-00022
Ann Intern Med. 2004;140(9):763. doi:10.7326/0003-4819-140-9-200405040-00023
Ann Intern Med. 2004;140(9):764. doi:10.7326/0003-4819-140-9-200405040-00024
Ann Intern Med. 2004;140(9):764. doi:10.7326/0003-4819-140-9-200405040-00025
Ann Intern Med. 2004;140(9):764-765. doi:10.7326/0003-4819-140-9-200405040-00026
Ann Intern Med. 2004;140(9):765-766. doi:10.7326/0003-4819-140-9-200405040-00027
Ann Intern Med. 2004;140(9):766-767. doi:10.7326/0003-4819-140-9-200405040-00028
Ann Intern Med. 2004;140(9):W-35. doi:10.7326/0003-4819-140-9-200405040-00028-w1
Ann Intern Med. 2004;140(9):W-36. doi:10.7326/0003-4819-140-9-200405040-00028-w2
Ann Intern Med. 2004;140(9):767. doi:10.7326/0003-4819-140-9-200405040-00029
Ann Intern Med. 2004;140(9):767. doi:10.7326/0003-4819-140-9-200405040-00030
Ann Intern Med. 2004;140(9):I-18. doi:10.7326/0003-4819-140-9-200405040-00001
Ann Intern Med. 2004;140(9):I-29. doi:10.7326/0003-4819-140-9-200405040-00002
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Ann Intern Med. 2004;140(9):I-82. doi:10.7326/0003-4819-140-9-200405040-00005
Ann Intern Med. 2004;140(9):I-88. doi:10.7326/0003-4819-140-9-200405040-00006
Joshua Wynne, MD, MBA, MPH; Susan I. Farkas, MD
Ann Intern Med. 2004;140(9):768. doi:10.7326/0003-4819-140-9-200405040-00033
Onyebuchi A. Arah, MD, DSc
Ann Intern Med. 2004;140(9):768. doi:10.7326/0003-4819-140-9-200405040-00034
Ann Intern Med. 2004;140(9):No Pagination Specified. doi:10.7326/0003-4819-140-9-200405040-00036