Jeffrey L. Lennox, MD; Raphael J. Landovitz, MD, MSc; Heather J. Ribaudo, PhD; Ighovwerha Ofotokun, MD, MSc; Lumine H. Na, MS; Catherine Godfrey, MD; Daniel R. Kuritzkes, MD; Manish Sagar, MD; Todd T. Brown, MD, PhD; Susan E. Cohn, MD, MPH; Grace A. McComsey, MD; Francesca Aweeka, PharmD; Carl J. Fichtenbaum, MD; Rachel M. Presti, MD, PhD; Susan L. Koletar, MD; David W. Haas, MD; Kristine B. Patterson, MD; Constance A. Benson, MD; Bryan P. Baugh, MD; Randi Y. Leavitt, MD, PhD; James F. Rooney, MD; Daniel Seekins, MD; Judith S. Currier, MD, MSc; for the ACTG A5257 Team
Nonnucleoside reverse transcriptase inhibitor (NNRTI)-based antiretroviral therapy is not suitable for all treatment-naive HIV-infected persons. This phase 3, open-label study evaluated 3 NNRTI-sparing initial antiretroviral regimens to show equivalence for virologic efficacy and tolerability. All 3 regimens attained high and equivalent rates of virologic control with some differences in tolerability and adverse effect profiles.
Ann Intern Med. 2014;161(7):461-471. doi:10.7326/M14-1084
L. Elizabeth Goldman, MD, MCR; Urmimala Sarkar, MD, MPH; Eric Kessell, PhD; David Guzman, MS; Michelle Schneidermann, MD; Edgar Pierluissi, MD; Barbara Walter, RN, MSN; Eric Vittinghoff, PhD, MPH; Jeff Critchfield, MD; Margot Kushel, MD
Hospitals are implementing discharge support programs to reduce readmissions, which have had mixed success. This trial in an ethnically and linguistically diverse community found that a nurse-led program including patient education and follow-up telephone contacts did not reduce hospital readmissions and may have increased emergency department encounters. Discharge programs require careful study to determine which will provide benefit or possible harm.
Ann Intern Med. 2014;161(7):472-481. doi:10.7326/M14-0094
Joseph A. Ladapo, MD, PhD; Saul Blecker, MD, MHS; Pamela S. Douglas, MD
Cardiac stress testing with imaging has fueled debate about rising health care costs and radiation exposure. The authors analyzed repeated cross-sectional data and U.S. trends in cardiac stress testing and found an overall steady increase over many years. Changes in population and provider characteristics contributed to this growth but not to the increase in cardiac tests with imaging.
Ann Intern Med. 2014;161(7):482-490. doi:10.7326/M14-0296
Erin D. Michos, MD, MHS; Lisa M. Wilson, ScM; Hsin-Chieh Yeh, PhD; Zackary Berger, MD, PhDs; Catalina Suarez-Cuervo, MD; Sylvie R. Stacy, MD; Eric B. Bass, MD, MPH
The prognostic value of troponin testing in patients with chronic kidney disease (CKD) without suspected acute coronary syndrome (ACS) is uncertain. This systematic review of 98 observational studies examined the value of troponin for risk stratification of patients with CKD without ACS. Elevated troponin levels were associated with worse prognosis. Studies did not evaluate whether troponin measures could help reclassify patients into high- and low-risk groups that might require different treatment.
Ann Intern Med. 2014;161(7):491-501. doi:10.7326/M14-0743
Sylvie R. Stacy, MD, MPH; Catalina Suarez-Cuervo, MD; Zackary Berger, MD, PhD; Lisa M. Wilson, ScM; Hsin-Chieh Yeh, PhD; Eric B. Bass, MD, MPH; Erin D. Michos, MD, MHS
Patients with CKD have high prevalence of elevated serum troponin levels, which make diagnosis of ACS challenging. This systematic review of 23 studies examined whether troponin levels can help diagnose or predict outcomes in patients with CKD and ACS. Elevated levels of troponin I or troponin T were associated with higher risk for adverse outcomes but had unclear utility for diagnosing ACS in patients with CKD.
Ann Intern Med. 2014;161(7):502-512. doi:10.7326/M14-0746
Adam G. Dunn, PhD; Diana Arachi, MPH, MA; Joel Hudgins, MD; Guy Tsafnat, PhD; Enrico Coiera, MBBS, PhD; Florence T. Bourgeois, MD, MPH
Industry funding and financial conflicts of interest may contribute to bias in the synthesis and interpretation of scientific evidence. This analysis of 26 systematic reviews of neuraminidase inhibitors found that reviewers with financial conflicts of interest were more likely to present evidence about neuraminidase inhibitors in a favorable manner and to recommend their use than those without financial conflicts of interest.
Ann Intern Med. 2014;161(7):513-518. doi:10.7326/M14-0933
Dora M. Dumont, PhD, MPH; Scott A. Allen, MD; Josiah D. Rich, MD, MPH
In 2013, Sesame Street launched a new character with an incarcerated father. This Muppet is another signal of the growing public awareness of the consequences of incarceration for the families of those imprisoned. This commentary evaluates the relationship between incarceration and health and calls for medical professionals to endorse evidence-based public policies, such as community-based health initiatives to diagnose and treat illnesses associated with the cycle of incarceration.
Ann Intern Med. 2014;161(7):522-523. doi:10.7326/M14-0080
Zoey Thill, MD, MPP; Marce Abare, MD, MPH; Aaron Fox, MD, MS
After release, many former prisoners are unemployed, which leads to lack of health insurance and a risk for worsening physical and mental illness. This commentary discusses how the exclusion of formerly incarcerated persons from the workforce may worsen health and propagate health disparities.
Ann Intern Med. 2014;161(7):524-525. doi:10.7326/M14-1674
Neil M. Kirschner, PhD; Lois Snyder Sulmasy, JD; Aaron S. Kesselheim, MD, JD, MPH
The Open Payments program, which originated as the Physician Payment Sunshine Act of 2007, requires the public reporting of financial relationships between industries and physicians and teaching hospitals. This article outlines the program and discusses implications of the program to physicians and their patients.
Ann Intern Med. 2014;161(7):519-521. doi:10.7326/M14-1303
Frank Davidoff, MD
In this issue, Goldman and colleagues evaluated an improvement intervention designed to reduce the rate of return emergency department visits and readmissions. The editorialist discusses how the study teaches us that improvement interventions need to be evaluated using methods that are appropriate for the unstable, context-dependent, and timedependent nature of social treatments—which is what improvement interventions are.
Ann Intern Med. 2014;161(7):526-527. doi:10.7326/M14-1789
William G. Kussmaul III, MD; Ashwini R. Sehgal, MD
In this issue, 2 systematic reviews address the challenges of using troponin levels to diagnose cardiac disease in patients with CKD. The editorialists discuss these findings and view them as a solid base for future research to optimize the renal and cardiac outcomes in these patients.
Ann Intern Med. 2014;161(7):528-529. doi:10.7326/M14-1630
Erin M. Denney-Koelsch, MD
The more years that I spend as a palliative care physician, the more I am aware of the whole arc of life and the agony of one life suddenly cut short.
Ann Intern Med. 2014;161(7):530. doi:10.7326/M14-0327
Ann Intern Med. 2014;161(7):531. doi:10.7326/L14-5019
Ann Intern Med. 2014;161(7):531-532. doi:10.7326/L14-5019-2
Ann Intern Med. 2014;161(7):532-533. doi:10.7326/L14-5019-3
Ann Intern Med. 2014;161(7):533. doi:10.7326/L14-5019-4
Ann Intern Med. 2014;161(7):533-534. doi:10.7326/L14-5019-5
Ann Intern Med. 2014;161(7):534. doi:10.7326/L14-5019-6
Ann Intern Med. 2014;161(7):534. doi:10.7326/L14-5019-7
Ann Intern Med. 2014;161(7):534-535. doi:10.7326/L14-5019-8
Ann Intern Med. 2014;161(7):535. doi:10.7326/L14-5019-9
Martin H. Ellbogen Jr., MD
Ann Intern Med. 2014;161(7):536. doi:10.7326/M14-1799
Philip A. Masters, MD
Ann Intern Med. 2014;161(7):ITC1. doi:10.7326/0003-4819-161-7-201410070-01004
Ann Intern Med. 2014;161(7):I-22. doi:10.7326/P14-9035
Ann Intern Med. 2014;161(7):I-28. doi:10.7326/P14-9036
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