Kathleen E. Bainbridge, PhD, MPH; Howard J. Hoffman, MA; Catherine C. Cowie, PhD, MPH
Using data from the National Health and Nutrition Examination Survey, 1994–2000, Bainbridge and colleagues found that hearing impairment was twice as prevalent in patients with diabetes than those without diabetes. This association was independent of known risk factors for hearing impairment. Physicians should be especially alert to the benefits of screening persons with diabetes for hearing impairment.
Ann Intern Med. 2008;149(1):1-10. doi:10.7326/0003-4819-149-1-200807010-00231
Elbert S. Huang, MD, MPH; Qi Zhang, PhD; Niren Gandra, BA; Marshall H. Chin, MD, MPH; David O. Meltzer, MD, PhD
In this decision analysis model to estimate the net benefits of treating to a hemoglobin A1c level of 7% rather than 7.9% among 60- to 80-year-old persons with several different life expectancies, net benefits of tight control ranged from 51 to 116 quality-adjusted days. Benefits decreased with advancing age and as life expectancy decreased, suggesting that the target hemoglobin A1c value can be higher in elderly people with comorbid disease.
Ann Intern Med. 2008;149(1):11-19. doi:10.7326/0003-4819-149-1-200807010-00005
Jeanne M. Marrazzo, MD, MPH; Katherine K. Thomas, MS; Tina L. Fiedler, BS; Kathleen Ringwood, MSW; David N. Fredricks, MD
Bacterial vaginosis often persists after treatment, possibly because of bacterial vaginosis–associated bacteria (BVAB). Among 335 women who have sex with women, Clostridia BVAB1, BVAB2, or BVAB3; Peptoniphilus lacrimalis; and Megasphaera phylotype 2 at baseline and lower adherence to treatment were associated with persistent bacterial vaginosis 1 month after treatment. Microbiological analysis at the time of diagnosis may predict treatment failure.
Ann Intern Med. 2008;149(1):20-28. doi:10.7326/0003-4819-149-1-200807010-00006
Robert M. Wachter, MD; Scott A. Flanders, MD; Christopher Fee, MD; Peter J. Pronovost, MD, PhD
The administration of antibiotics within 4 hours to patients with community-acquired pneumonia is a widely used, but often criticized, quality-of-care measure. The authors make 5 recommendations for future development of publicly reported quality measures.
Ann Intern Med. 2008;149(1):29-32. doi:10.7326/0003-4819-149-1-200807010-00007
Eric Bateman, MD; Harold Nelson, MD; Jean Bousquet, MD; Kenneth Kral, MS; Laura Sutton, PharmD; Hector Ortega, MD, ScD; Steven Yancey, MS
Many question whether adding long-acting β-agonists to treatment regimens of patients whose asthma is not controlled with inhaled corticosteroids alone is safe. In 66 GlaxoSmithKline trials involving 20 966 patients with persistent asthma, twice-daily 50-µg salmeterol plus inhaled corticosteroids did not seem to alter risk for asthma-related hospitalizations but decreased risk for severe exacerbations requiring systemic corticosteroids. One asthma-related death and 1 intubation occurred in patients receiving combination therapy.
Ann Intern Med. 2008;149(1):33-42. doi:10.7326/0003-4819-149-1-200807010-00229
U.S. Preventive Services Task Force
The U.S. Preventive Services Task Force (USPSTF) reaffirms their 2004 recommendation to screen for asymptomatic bacteriuria with urine culture in pregnant women at 12 to 16 weeks' gestation or at the first prenatal visit, if later (grade A recommendation). They do not recommend screening for asymptomatic bacteriuria in men and nonpregnant women (grade D recommendation).
Ann Intern Med. 2008;149(1):43-47. doi:10.7326/0003-4819-149-1-200807010-00009
Kenneth Lin, MD; Kevin Fajardo, MD, MPH, MTMH
Lin and Fajardo's systematic review supports the USPSTF recommendation in this issue on screening for asymptomatic bacteriuria. This article is only available at www.annals.org.
Ann Intern Med. 2008;149(1):W-20-W-24. doi:10.7326/0003-4819-149-1-200807010-00009-w1
Jeffrey T. Berger, MD; Evan G. DeRenzo, PhD; Jack Schwartz, JD
Many adult patients do not have the cognitive capacity to make decisions and must rely on surrogates. The basis for surrogates' decisions is typically the patients' known wishes, what the surrogate thinks the patient would decide, or the patient's supposed best interests. However, this framework has limitations. The authors review research on surrogate decision making, compare actual practice with normative standards, and offer ways to improve practice.
Ann Intern Med. 2008;149(1):48-53. doi:10.7326/0003-4819-149-1-200807010-00010
Keiko Hirose, MD
In this issue, Bainbridge and colleagues report that people with diabetes in the National Health and Nutrition Examination Survey had increased risk for hearing loss compared with nondiabetic persons. Their study opens up potential directions for future research, in terms of medical or surgical therapies that may halt the progression of diabetic cochleopathy, whether tighter glycemic control has a protective effect against the development of hearing loss, and the clinical implications of diabetes-related hearing loss.
Ann Intern Med. 2008;149(1):54-55. doi:10.7326/0003-4819-149-1-200807010-00232
Kevin B. Weiss, MD
In this issue, Bateman and colleagues combined patient data from randomized efficacy trials to determine whether incidence of severe asthma-related events differs in persons receiving salmeterol plus inhaled corticosteroids versus inhaled corticosteroids alone. Although the study is well executed and uses sound methods, the data source has limitations. The best advice in the absence of new data may be to use combination therapy only for indications that accord with nationally accepted clinical guidelines, and to not use long-acting β-agonists as first-line treatment.
Ann Intern Med. 2008;149(1):56-57. doi:10.7326/0003-4819-149-1-200807010-00230
The Editors review changes and accomplishments from the past year at Annals.
Ann Intern Med. 2008;149(1):58-59. doi:10.7326/0003-4819-149-1-200807010-00013
David Muller, MD
Ann Intern Med. 2008;149(1):60. doi:10.7326/0003-4819-149-1-200807010-00014
Terry L. Wahls, MD, MBA
Ann Intern Med. 2008;149(1):61-62. doi:10.7326/0003-4819-149-1-200807010-00015
Ann Intern Med. 2008;149(1):63. doi:10.7326/0003-4819-149-1-200807010-00016
Ann Intern Med. 2008;149(1):63-64. doi:10.7326/0003-4819-149-1-200807010-00017
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Ann Intern Med. 2008;149(1):64-65. doi:10.7326/0003-4819-149-1-200807010-00019
Ann Intern Med. 2008;149(1):65. doi:10.7326/0003-4819-149-1-200807010-00020
Ann Intern Med. 2008;149(1):66. doi:10.7326/0003-4819-149-1-200807010-00021
Ann Intern Med. 2008;149(1):66. doi:10.7326/0003-4819-149-1-200807010-00022
Ann Intern Med. 2008;149(1):66-67. doi:10.7326/0003-4819-149-1-200807010-00023
Ann Intern Med. 2008;149(1):67. doi:10.7326/0003-4819-149-1-200807010-00024
Ann Intern Med. 2008;149(1):67-68. doi:10.7326/0003-4819-149-1-200807010-00025
Ann Intern Med. 2008;149(1):68-69. doi:10.7326/0003-4819-149-1-200807010-00026
Ann Intern Med. 2008;149(1):69-71. doi:10.7326/0003-4819-149-1-200807010-00027
Ann Intern Med. 2008;149(1):71-72. doi:10.7326/0003-4819-149-1-200807010-00028
Susan V. Bershad, MD
Ann Intern Med. 2008;149(1):ITC1-1. doi:10.7326/0003-4819-149-1-200807010-01001
Ann Intern Med. 2008;149(1):I-30. doi:10.7326/0003-4819-149-1-200807010-00002
Ann Intern Med. 2008;149(1):I-37. doi:10.7326/0003-4819-149-1-200807010-00003
Ann Intern Med. 2008;149(1):I-20. doi:10.7326/0003-4819-149-1-200807010-00233
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