Shoshana M. Rosenberg, ScD, MPH; Michaela S. Tracy, BA; Meghan E. Meyer, BS; Karen Sepucha, PhD; Shari Gelber, MS, MSW; Judi Hirshfield-Bartek, MS; Susan Troyan, MD; Monica Morrow, MD; Lidia Schapira, MD; Steven E. Come, MD; Eric P. Winer, MD; Ann H. Partridge, MD, MPH
Young women with breast cancer are increasingly undergoing contralateral prophylactic mastectomy. In this survey of women aged 40 years or younger with unilateral breast cancer who had undergone bilateral mastectomy, common reasons for choosing contralateral prophylactic mastectomy were desires to avoid contralateral breast cancer and to improve survival. Women often overestimated the risk for contralateral breast cancer, but few believed that bilateral mastectomy improved survival.
Ann Intern Med. 2013;159(6):373-381. doi:10.7326/0003-4819-159-6-201309170-00003
Kevin F. Erickson, MD, MS; Glenn M. Chertow, MD, MPH; Jeremy D. Goldhaber-Fiebert, PhD
A previous randomized trial showed that tolvaptan reduced kidney volume growth and loss of kidney function over 3 years in persons with autosomal dominant polycystic kidney disease. This modeling study simulated outcomes and cost-effectiveness if tolvaptan's benefits persisted indefinitely. The researchers estimated that tolvaptan would slow progression to end-stage renal disease and reduce mortality rates, but its cost-effectiveness would not compare favorably with other common medical interventions.
Ann Intern Med. 2013;159(6):382-389. doi:10.7326/0003-4819-159-6-201309170-00004
Robert M. Anthenelli, MD; Chad Morris, PhD; Tanya S. Ramey, MD, PhD; Sarah J. Dubrava, MS; Kostas Tsilkos, MD; Cristina Russ, MD; Carla Yunis, MD, MPH
Varenicline increases quit rates in smokers, but its efficacy and safety in patients with psychiatric disorders are unclear. This trial randomly assigned smokers with stable treated current or past major depression and no recent cardiovascular disease to varenicline or placebo for 12 weeks. More varenicline recipients stopped smoking. It may be suitable for smoking cessation in some smokers with stable depression without exacerbating depression or anxiety.
Ann Intern Med. 2013;159(6):390-400. doi:10.7326/0003-4819-159-6-201309170-00005
John M. Hollingsworth, MD, MS; Mary A.M. Rogers, PhD; Sarah L. Krein, PhD, RN; Andrew Hickner, MSI; Latoya Kuhn, MPH; Alex Cheng, MD; Robert Chang, MD; Sanjay Saint, MD, MPH
Little is known about noninfectious complications resulting from urethral catheter use. This systematic review and meta-analysis examined studies describing such complications and pooled data to estimate their frequency. It found that noninfectious complications are common. The most frequent complications are minor (such as urine leakage), but serious complications (such as urethral strictures and gross hematuria) occur in a substantial proportion of catheter recipients.
Ann Intern Med. 2013;159(6):401-410. doi:10.7326/0003-4819-159-6-201309170-00006
Linda L. Humphrey, MD, MPH; Mark Deffebach, MD; Miranda Pappas, MA; Christina Baumann, MD, MPH; Kathryn Artis, MD, MPH; Jennifer Priest Mitchell, BA; Bernadette Zakher, MBBS; Rongwei Fu, PhD; Christopher G. Slatore, MD, MS
Early-stage lung cancer is associated with lower mortality than late-stage disease; thus, early detection and treatment may be beneficial. This systematic review updates evidence on the effectiveness and harms of low-dose computed tomography screening for lung cancer for the U.S. Preventive Services Task Force. It found that screening high-risk smokers who had at least a 30–pack-year history with low-dose computed tomography reduced lung cancer–related and all-cause mortality.
Ann Intern Med. 2013;159(6):411-420. doi:10.7326/0003-4819-159-6-201309170-00690
Marshall B. Kapp, JD, MPH
In the U.S. debate about gun control, concern has centered on the safety of people, particularly children, who live in homes with guns. However, gun safety is also an issue in homes in which elderly people reside. This commentary presents an argument for why physicians should routinely ask older patients about their access to guns and address safety concerns when they exist.
Ann Intern Med. 2013;159(6):421-422. doi:10.7326/0003-4819-159-5-201309030-00682
Carl E. Fisher, MD; Jeffrey A. Lieberman, MD
Mental illness has figured prominently in the public dialogue about gun violence. This commentary expresses concern regarding the conflation of mental illness and gun violence—not only in the popular press but also in the academic literature. The authors believe that rhetoric too often portrays people with mental disorders as a greater part of the problem of gun violence than they actually are.
Ann Intern Med. 2013;159(6):423-424. doi:10.7326/0003-4819-159-5-201309030-00679
Mathias Lichterfeld, MD, PhD; Eric S. Rosenberg, MD
Diagnosis of acute HIV-1 infection is infrequently considered and rarely made, but an estimated 50 000 persons in the United States are newly infected each year. This commentary discusses the diagnosis and treatment of this disease. The authors believe that making the diagnosis, counseling patients about their diagnosis, and considering therapy to prevent virus transmission should serve as a “call to action” in managing patients with acute HIV-1.
Ann Intern Med. 2013;159(6):425-427. doi:10.7326/0003-4819-159-6-201309170-00010
Pamela R. Portschy, MD; Todd M. Tuttle, MD, MS
In this issue, Rosenberg and colleagues evaluated preferences, knowledge, decision making, and experiences of young women with breast cancer who chose contralateral prophylactic mastectomy and found that these women markedly overestimate their risk for contralateral breast cancer. The editorialists discuss the study and its findings and conclude that the discordance between patient perceptions and realistic expectations provides a teachable opportunity for physicians treating patients newly diagnosed with breast cancer.
Ann Intern Med. 2013;159(6):428-429. doi:10.7326/0003-4819-159-6-201309170-00011
Delphine S. Tuot, MDCM, MAS; Neil R. Powe, MD, MPH, MBA
In this issue, Erickson and colleagues add to the discussion of health care value by studying the cost-effectiveness of tolvaptan, a new medication for persons with autosomal dominant polycystic kidney disease. The editorialists discuss the study and its findings but conclude that regardless of tolvaptan's cost-effectiveness, questions about appropriate use remain.
Ann Intern Med. 2013;159(6):430-431. doi:10.7326/0003-4819-159-6-201309170-00012
Markus Donix, MD
In a psychiatry department specializing in affective disorders, lectures and seminars on depression are nothing unusual. Over the years we had learned what to expect: stories of fragile recovery, reflected by the patient's ability to participate in such an event, and the inherent risk for symptom relapse.
Ann Intern Med. 2013;159(6):432. doi:10.7326/0003-4819-159-6-201309170-00013
Andrew D. Coates, MD
Influenza rocked our community hospital for weeks this winter just as the first snowstorms came. On reflection, the experience left me feeling less like a doctor and more like a hapless worker bee in a buzzing but somehow misguided hive, fraught with unnecessary and avoidable endeavors.
Ann Intern Med. 2013;159(6):433-434. doi:10.7326/0003-4819-159-6-201309170-00014
Ann Intern Med. 2013;159(6):435. doi:10.7326/0003-4819-159-6-201309170-00016
Ann Intern Med. 2013;159(6):435. doi:10.7326/0003-4819-159-6-201309170-00017
Ann Intern Med. 2013;159(6):435-436. doi:10.7326/0003-4819-159-6-201309170-00018
Ann Intern Med. 2013;159(6):436. doi:10.7326/0003-4819-159-6-201309170-00019
Corey D. Fogleman, MD
Ann Intern Med. 2013;159(6):434. doi:10.7326/0003-4819-159-6-201309030-00015
Ann Intern Med. 2013;159(6):JC2. doi:10.7326/0003-4819-159-6-201309170-02002
Ann Intern Med. 2013;159(6):JC3. doi:10.7326/0003-4819-159-6-201309170-02003
Ann Intern Med. 2013;159(6):JC4. doi:10.7326/0003-4819-159-6-201309170-02004
Ann Intern Med. 2013;159(6):JC5. doi:10.7326/0003-4819-159-6-201309170-02005
Ann Intern Med. 2013;159(6):JC6. doi:10.7326/0003-4819-159-6-201309170-02006
Ann Intern Med. 2013;159(6):JC7. doi:10.7326/0003-4819-159-6-201309170-02007
Ann Intern Med. 2013;159(6):JC8. doi:10.7326/0003-4819-159-6-201309170-02008
Ann Intern Med. 2013;159(6):JC9. doi:10.7326/0003-4819-159-6-201309170-02009
Ann Intern Med. 2013;159(6):JC10. doi:10.7326/0003-4819-159-6-201309170-02010
Ann Intern Med. 2013;159(6):JC11. doi:10.7326/0003-4819-159-6-201309170-02011
Ann Intern Med. 2013;159(6):JC12. doi:10.7326/0003-4819-159-6-201309170-02012
Ann Intern Med. 2013;159(6):JC13. doi:10.7326/0003-4819-159-6-201309170-02013
Geno J. Merli, MD; Howard H. Weitz, MD
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.
Ann Intern Med. 2013;159(6):CG1. doi:10.7326/G13-3001
Ann Intern Med. 2013;159(6):CG2. doi:10.7326/G13-3002
Ann Intern Med. 2013;159(6):I-30. doi:10.7326/0003-4819-159-6-201309170-00001
Ann Intern Med. 2013;159(6):I-36. doi:10.7326/0003-4819-159-6-201309170-00002
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