Eric Jutkowitz, BA; Hyon K. Choi, MD, DrPH; Laura T. Pizzi, PharmD, MPH; Karen M. Kuntz, ScD
Gout is the most common inflammatory arthritis in the United States, but previous cost-effectiveness analyses of febuxostat therapy for gout did not include comparisons with escalating doses of allopurinol. This study used mathematical models to compare costs and quality-adjusted life-years of allopurinol and febuxostat in various single, sequential, dose-escalation, and fixed-dosing regimens.
Ann Intern Med. 2014;161(9):617-626. doi:10.7326/M14-0227
Paul F. Pinsky, PhD; David S. Gierada, MD; William Hocking, MD; Edward F. Patz Jr., MD; Barnett S. Kramer, MD, MPH
The National Lung Screening Trial showed that screening high-risk persons with low-dose computed tomography (LDCT) reduced lung cancer mortality. This secondary analysis of the trial reports that lung cancer prevalence and the positive predictive value of LDCT were higher in participants aged 65 years or older than in those younger than 65 years and the rate of false-positive screening results was higher in the older group. Screen-detected cancer was treated similarly in both groups.
Ann Intern Med. 2014;161(9):627-633. doi:10.7326/M14-1484
Anu Osinusi, MD; Anita Kohli, MD; Miriam M. Marti, BS; Amy Nelson, RN; Xiaozhen Zhang, MS; Eric G. Meissner, MD, PhD; Rachel Silk, RN; Kerry Townsend, BA; Phillip S. Pang, MD, PhD; G. Mani Subramanian, MD, PhD; John G. McHutchison, MD; Anthony S. Fauci, MD; Henry Masur, MD; Shyam Kottilil, MD, PhD
Sofosbuvir plus ribavirin therapy is used to treat chronic hepatitis C virus genotype 1 infection in patients who are ineligible for interferon. However, some patients will have relapse. This open-label study assessed the safety and efficacy of sofosbuvir plus ledipasvir in patients whose disease relapsed after sofosbuvir plus ribavirin therapy. The results suggest that re-treatment with sofosbuvir plus ledipasvir can be successful.
Ann Intern Med. 2014;161(9):634-638. doi:10.7326/M14-1211
Marcio L. Griebeler, MD; Oscar L. Morey-Vargas, MD; Juan P. Brito, MD; Apostolos Tsapas, MD, PhD; Zhen Wang, PhD; Barbara G. Carranza Leon, MD; Olivia J. Phung, PharmD; Victor M. Montori, MD; M. Hassan Murad, MD, MPH
Multiple treatments for painful diabetic peripheral neuropathy are available, but evidence-based guidance about the comparative effectiveness of these treatment options is lacking. This umbrella systematic review and network meta-analysis evaluates the comparative effectiveness of oral and topical analgesics for diabetic neuropathy. Although several medications are effective for short-term management of painful diabetic neuropathy, their comparative effectiveness remains unclear.
Ann Intern Med. 2014;161(9):639-649. doi:10.7326/M14-0511
Shadi Kalantarian, MD, MPH; Hakan Ay, MD; Randy L. Gollub, MD, PhD; Hang Lee, PhD; Kallirroi Retzepi, MSc; Moussa Mansour, MD; Jeremy N. Ruskin, MD
Atrial fibrillation is a common cause of stroke, but its association with silent cerebral infarctions is unclear. This systematic review estimated the association between atrial fibrillation and silent cerebral infarctions, as well as the prevalence of silent cerebral infarctions in patients with atrial fibrillation and no history of stroke. The authors found that atrial fibrillation was associated with a 2-fold increase in the odds for a silent cerebral infarction.
Ann Intern Med. 2014;161(9):650-658. doi:10.7326/M14-0538
Amir Qaseem, MD, PhD; Paul Dallas, MD; Mary Ann Forciea, MD; Melissa Starkey, PhD; Thomas D. Denberg, MD, PhD; for the Clinical Guidelines Committee of the American College of Physicians
This American College of Physicians (ACP) guideline on dietary and pharmacologic management to prevent recurrent nephrolithiasis in adults recommends management with increased fluid intake spread throughout the day to achieve at least 2 L of urine per day to prevent recurrent nephrolithiasis. If increased fluid intake fails to reduce stone formation, ACP recommends pharmacologic monotherapy with a thiazide diuretic, citrate, or allopurinol.
Ann Intern Med. 2014;161(9):659-667. doi:10.7326/M13-2908
Richard E. Rieselbach, MD; Paul H. Rockey, MD, MPH; Robert L. Phillips Jr., MD, MSPH; Kathleen Klink, MD; Malcolm Cox, MD
Federal funds support graduate medical education positions, but expansion is needed in urban and rural areas that experience shortages in health professionals. This commentary discusses the need for existing funds to be used to expand primary care training programs and thus improve access to care in underserved areas.
Ann Intern Med. 2014;161(9):668-669. doi:10.7326/M14-1838
Knut Lönnroth, MD, PhD, MSc; Giovanni Battista Migliori, MD; Mario Raviglione, MD
In July 2014, participants from 36 countries and experts in the field met to discuss a global framework for eliminating tuberculosis in low-incidence countries. This commentary discusses the framework for elimination, which will require high-level political commitment, strong public health programs, social justice, international solidarity, and investment in research.
Ann Intern Med. 2014;161(9):670-671. doi:10.7326/M14-1888
Michael K. Gould, MD, MS
In this issue, Pinsky and colleagues present the results of their secondary analysis of data from the National Lung Screening Trial, in which they compared outcomes of screening with LDCT between Medicare-eligible and younger participants. The editorialist discusses the findings and their implications for clinicians and policymakers.
Ann Intern Med. 2014;161(9):672-673. doi:10.7326/M14-2006
Brian C. Callaghan, MD, MS; Eva L. Feldman, MD, PhD
In this issue, Griebeler and colleagues' umbrella systematic review and network meta-analysis evaluates the comparative effectiveness of oral and topical analgesics for diabetic neuropathy. The editorialists discuss how patient comorbid conditions, potential adverse effects, and cost can help physicians decide which medications to prescribe until more evidence is available.
Ann Intern Med. 2014;161(9):674-675. doi:10.7326/M14-2157
Ross M. Boyce, MD, MSc
Nearly 10 years ago, at the age of 25, I crossed the border into Iraq as the commander of an infantry platoon. No one knew what lay ahead, but we all knew there was no turning back.
Ann Intern Med. 2014;161(9):676-677. doi:10.7326/M14-1054
Ann Intern Med. 2014;161(9):678. doi:10.7326/L14-5021
Ann Intern Med. 2014;161(9):678-679. doi:10.7326/L14-5021-2
Ann Intern Med. 2014;161(9):679. doi:10.7326/L14-5021-4
Ann Intern Med. 2014;161(9):679-680. doi:10.7326/L14-5021-5
Ann Intern Med. 2014;161(9):680. doi:10.7326/L14-5021-6
Ann Intern Med. 2014;161(9):680. doi:10.7326/L14-5021-7
Jay S. Balachandran, MD; Sanjay R. Patel, MD, MS
Ann Intern Med. 2014;161(9):ITC1. doi:10.7326/0003-4819-161-9-201411040-01005
Ann Intern Med. 2014;161(9):I-24. doi:10.7326/P14-9038
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