Mohammed K. Ali, MBChB, MSc, MBA; Kai McKeever Bullard, MPH, PhD; Edward W. Gregg, PhD; Carlos del Rio, MD
The “cascade-of-care” concept documents how patients move from diagnosis to treatment and follow-up care. This model has been helpful in identifying gaps in HIV care that result in patients not receiving needed care but has not been widely applied to diseases, such as diabetes. This study used data from NHANES (National Health Nutrition Examination Surveys) to apply the cascade-of-care model to U.S. diabetes care to help visualize gaps in awareness of diagnosis, engagement, and treatment.
Ann Intern Med. 2014;161(10):681-689. doi:10.7326/M14-0019
Morten Lamberts, MD, PhD; Gregory Y.H. Lip, MD; Morten Lock Hansen, MD, PhD; Jesper Lindhardsen, MD, PhD; Jonas Bjerring Olesen, MD, PhD; Jakob Raunsø, MD, PhD; Anne-Marie Schjerning Olsen, MD, PhD; Per Kragh Andersen, PhD, DMSc; Thomas Alexander Gerds, Dr Rer Nat; Emil L. Fosbøl, MD, PhD; Christian Torp-Pedersen, MD, DMSc; Gunnar H. Gislason, MD, PhD
Antithrombotic therapy is a cornerstone of management of atrial fibrillation (AF). The association between nonsteroidal anti-inflammatory drugs (NSAIDs) and serious bleeding in patients with AF who are receiving antithrombotic medication is unknown. This study examined all citizens of Denmark who had a first-time diagnosis of AF during a hospitalization between 1997 and 2011. It found that NSAIDs increased the risk for bleeding and thromboembolism, even when they were used for short periods.
Ann Intern Med. 2014;161(10):690-698. doi:10.7326/M13-1581
Sachin S. Goel, MD; Olcay Aksoy, MD; Supriya Gupta, MD; Penny L. Houghtaling, MS; E. Murat Tuzcu, MD; Thomas Marwick, MBBS, PhD, MPH; Tomislav Mihaljevic, MD; Lars Svensson, MD, PhD; Eugene H. Blackstone, MD; Brian P. Griffin, MD; William J. Stewart, MD; Benico Barzilai, MD; Venu Menon, MD; Samir R. Kapadia, MD
Little is known about the effect of renin–angiotensin system (RAS) blockade therapy after surgical aortic valve replacement for severe aortic stenosis. This cohort study investigated the association between RAS blockade therapy with angiotensin-converting enzyme inhibitors or angiotensin-receptor blockers and outcomes, such as survival rates and changes in left ventricular mass index, left ventricular ejection fraction, and left atrial size. It found that RAS blockade therapy was associated with increased survival rates and encourages further study of the therapy's benefits.
Ann Intern Med. 2014;161(10):699-710. doi:10.7326/M13-1505
Carolyn J. Crandall, MD, MS; Sydne J. Newberry, PhD; Allison Diamant, MD, MSHS; Yee-Wei Lim, MD, PhD; Walid F. Gellad, MD, MPH; Marika J. Booth, MS; Aneesa Motala, BA; Paul G. Shekelle, MD, PhD
This comprehensive update addresses the benefits and harms of pharmacologic treatments used to prevent fractures in adults at increased risk. The authors found good-quality evidence that several medications, including bisphosphonates, denosumab, and teriparatide, reduce fracture risk. Side effect profiles and frequency varied among drugs, and atypical subtrochanteric fracture and osteonecrosis of the jaw were rare risks.
Ann Intern Med. 2014;161(10):711-723. doi:10.7326/M14-0317
Benny Tu, MBBS; Ben Rich, PhD; Christopher Labos, MD, CM, MSc; James M. Brophy, MD, PhD
The optimal revascularization technique for patients with coronary artery disease and diabetes is an important unresolved question. This review compared long-term outcomes between percutaneous coronary intervention and coronary artery bypass grafting in patients with diabetes. The latter technique seemed to lead to better coronary artery disease outcomes but increased risk for stroke. Clinical judgment is required when choosing a revascularization technique for patients with diabetes.
Ann Intern Med. 2014;161(10):724-732. doi:10.7326/M14-0808
Kira L. Ryskina, MD; Deborah Korenstein, MD; Arlene Weissman, PhD; Philip Masters, MD; Patrick Alguire, MD; Cynthia D. Smith, MD
Although balancing benefits of tests or treatments against potential harms and costs has been a recently emphasized competency for internal medicine residents, few tools to assess knowledge in this domain are available. This study developed a high-value care subscore calculated from selected items on the Internal Medicine In-Training Examination and evaluated the relationship of program-level performance on this subscore to the Dartmouth Atlas hospital care intensity index.
Ann Intern Med. 2014;161(10):733-739. doi:10.7326/M14-0444
Warren K. Laskey, MD, MPH
Percutaneous coronary intervention has become the preferred method for managing patients with coronary artery disease, especially since the introduction of drug-eluting stents (DESs), which have a lower risk for in-stent restenosis. This commentary reminds us that more work must be done to improve risk stratification at the outset and identify appropriate candidates for DESs.
Ann Intern Med. 2014;161(10):740-741. doi:10.7326/M14-0874
Scott H. Podolsky, MD
Two American missionary workers infected with Ebola virus were administered a combination of preformed monoclonal antibodies previously demonstrated to work only in monkeys. This commentary discusses the history of serotherapy in the United States and what lessons we can learn from it.
Ann Intern Med. 2014;161(10):742-743. doi:10.7326/M14-1810
Nancy Kass, ScD
Two U.S. aid workers with Ebola were evacuated to the United States and treated with an extremely scarce and untested therapy. This commentary discusses whether, given the hundreds of similarly stricken patients in Africa, singling out the Americans for such heroic care was ethical.
Ann Intern Med. 2014;161(10):744-745. doi:10.7326/M14-1864
Carlos del Rio, MD; Aneesh K. Mehta, MD; G. Marshall Lyon III, MD; Jeannette Guarner, MD
That a patient with Ebola could travel to the United States has created unprecedented media coverage and widespread concern. This commentary emphasizes the importance of clinicians understanding the epidemiology and pathogenesis of Ebola to better serve patients and the public.
Ann Intern Med. 2014;161(10):746-748. doi:10.7326/M14-1880
Alison P. Galvani, PhD; Martial L. Ndeffo-Mbah, PhD; Natasha Wenzel, MPH; James E. Childs, PhD
The ongoing epidemic in West Africa is the largest Ebola outbreak ever recorded and is rapidly crossing borders. The authors of this commentary discuss viable Ebola vaccine candidates and believe the time to deploy a vaccine is now.
Ann Intern Med. 2014;161(10):749-750. doi:10.7326/M14-1904
Michael Klompas, MD, MPH; Daniel J. Diekema, MD; Neil O. Fishman, MD; Deborah S. Yokoe, MD
The authors of this commentary believe that current recommendations from the Centers for Disease Control and Prevention to prevent transmission of Ebola to health care workers are appropriate. Additional measures, such as full-body hazardous material suits, may paradoxically increase the risk for transmission.
Ann Intern Med. 2014;161(10):751-752. doi:10.7326/M14-1918
William A. Fischer II, MD; Noreen A. Hynes, MD, MPH; Trish M. Perl, MD, MSc
The authors of this commentary discuss how so many health care workers in West Africa could have become infected with Ebola despite the known effectiveness of barrier protection in blocking its transmission.
Ann Intern Med. 2014;161(10):753-754. doi:10.7326/M14-1953
Heike A. Bischoff-Ferrari, MD, DrPH; Otto Meyer, MD
In this issue, Crandall and colleagues report a systematic review of the comparative effectiveness of pharmacologic treatments to prevent fractures. The editorialists discuss the review and caution that while it provides helpful information to guide clinical decision making, its findings may not apply to patients aged 75 years or older and those aged 80 years or older with nonskeletal risk factors for falls.
Ann Intern Med. 2014;161(10):755-756. doi:10.7326/M14-1942
This issue is accompanied by an electronic supplement featuring the work of current and former Robert Wood Johnson Foundation (RWJF) Clinical Scholars. The theme of these articles is the pursuit of health care value through evaluation of practical interventions for common clinical problems. The supplement is available at www.annals.org.
Ann Intern Med. 2014;161(10):757. doi:10.7326/M14-2323
Jean-Noel Vergnes, DDS, PhD
Ann Intern Med. 2014;161(10):758-759. doi:10.7326/M14-1076
Ann Intern Med. 2014;161(10):760. doi:10.7326/L14-5022
Ann Intern Med. 2014;161(10):760. doi:10.7326/L14-5023
Ann Intern Med. 2014;161(10):760-761. doi:10.7326/L14-5023-2
Ann Intern Med. 2014;161(10):761. doi:10.7326/L14-5023-3
Ann Intern Med. 2014;161(10):761-762. doi:10.7326/L14-5024
Ann Intern Med. 2014;161(10):762. doi:10.7326/L14-5024-2
Ann Intern Med. 2014;161(10):762-763. doi:10.7326/L14-5025
Ann Intern Med. 2014;161(10):763. doi:10.7326/L14-5025-2
Ann Intern Med. 2014;161(10):763-764. doi:10.7326/L14-5026
Ann Intern Med. 2014;161(10):764. doi:10.7326/L14-5026-1
Ann Intern Med. 2014;161(10):764. doi:10.7326/L14-5026-2
Ann Intern Med. 2014;161(10):JC2. doi:10.7326/0003-4819-161-10-201411180-02002
Ann Intern Med. 2014;161(10):JC3. doi:10.7326/0003-4819-161-10-201411180-02003
Ann Intern Med. 2014;161(10):JC4. doi:10.7326/0003-4819-161-10-201411180-02004
Ann Intern Med. 2014;161(10):JC5. doi:10.7326/0003-4819-161-10-201411180-02005
Ann Intern Med. 2014;161(10):JC6. doi:10.7326/0003-4819-161-10-201411180-02006
Ann Intern Med. 2014;161(10):JC7. doi:10.7326/0003-4819-161-10-201411180-02007
Ann Intern Med. 2014;161(10):JC8. doi:10.7326/0003-4819-161-10-201411180-02008
Ann Intern Med. 2014;161(10):JC9. doi:10.7326/0003-4819-161-10-201411180-02009
Ann Intern Med. 2014;161(10):JC10. doi:10.7326/0003-4819-161-10-201411180-02010
Ann Intern Med. 2014;161(10):JC11. doi:10.7326/0003-4819-161-10-201411180-02011
Ann Intern Med. 2014;161(10):JC12. doi:10.7326/0003-4819-161-10-201411180-02012
Ann Intern Med. 2014;161(10):JC13. doi:10.7326/0003-4819-161-10-201411180-02013
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. 2014;161(10):CG11. doi:10.7326/G14-3011
Ann Intern Med. 2014;161(10):I-38. doi:10.7326/P14-9039
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