Issues

Yoji Takeuchi, MD; Katsuhiro Mabe, MD, PhD; Yuichi Shimodate, MD; Shinji Yoshii, MD, PhD; Shinya Yamada, MD; Mineo Iwatate, MD, PhD; Takuji Kawamura, MD, PhD; Kinichi Hotta, MD; Koji Nagaike, MD; Nobuaki Ikezawa, MD; Tomoaki Yamasaki, MD; Yoriaki Komeda, MD, PhD; Satoshi Asai, MD; Yasuhiro Abe, MD; Takuji Akamatsu, MD, PhD; Yuko Sakakibara, MD; Hisatomo Ikehara, MD, PhD; Yuzuru Kinjo, MD; Takashi Ohta, MD; Yoko Kitamura, MD; Takashi Shono, MD, PhD; Takuya Inoue, MD, PhD; Yoshio Ohda, MD, PhD; Nozomu Kobayashi, MD; Tokuma Tanuma, MD, PhD; Ryu Sato, MD; Taku Sakamoto, MD, PhD; Naohiko Harada, MD, PhD; Akiko Chino, MD, PhD; Hideki Ishikawa, MD, PhD; Masanori Nojima, MD, PhD, MPH; Toshio Uraoka, MD, PhD; for the Madowazu Study Group

Long-term anticoagulant therapy is associated with an increased risk for hemorrhage in patients undergoing polypectomy. Furthermore, the type of procedure (cold vs. hot snare) also may increase risk for bleeding. Guidelines vary regarding periprocedural anticoagulant management. This trial compared outcomes between patients who had continuous anticoagulation and cold snare polypectomy with those who received heparin bridging and hot snare polypectomy.

Ann Intern Med. 2019;171(4):229-237. doi:10.7326/M19-0026

Lauren J. Ralph, PhD; Eleanor Bimla Schwarz, MD; Daniel Grossman, MD; Diana Greene Foster, PhD

This study examines the self-reported physical health of women who sought abortion over 5 years after either receiving or being denied abortion services. Although some argue that abortion is detrimental to women's health, these data provide evidence that suggests otherwise.

Ann Intern Med. 2019;171(4):238-247. doi:10.7326/M18-1666

Chintan V. Dave, PharmD, PhD; Sebastian Schneeweiss, MD, ScD; Dae Kim, MD, MPH, ScD; Michael Fralick, MD, SM; Angela Tong, MS; Elisabetta Patorno, MD, DrPH

Some studies have suggested an increased risk for urinary tract infections with sodium–glucose cotransporter-2 (SGLT-2) inhibitor treatment, whereas other studies did not find an increased risk. In this analysis of 2 U.S. commercial claims databases, the authors compared risk for severe urinary tract infections among patients who initiated SGLT-2 inhibitor therapy compared with patients who initiated treatment with dipeptidyl peptidase-4 inhibitors or glucagon-like peptide-1 receptor agonists.

Ann Intern Med. 2019;171(4):248-256. doi:10.7326/M18-3136

Larissa Grigoryan, MD, PhD; George Germanos, MD; Roger Zoorob, MD, MPH; Shivanki Juneja; Jean L. Raphael, MD, MPH; Michael K. Paasche-Orlow, MD, MA, MPH; Barbara W. Trautner, MD, PhD

This scoping review examines the prevalence of nonprescription antibiotic use in the United States and factors influencing this unsafe practice.

Ann Intern Med. 2019;171(4):257-263. doi:10.7326/M19-0505

Jeffrey A. Marbach, MBBS, MS; Aws Almufleh, MBBS, MPH; Pietro Di Santo, MD; Richard Jung, BSc; Trevor Simard, MD; Matthew McInnes, MD, PhD; Jean-Paul Salameh, BSc; Trevor A. McGrath, MD; Scott J. Millington, MD; Gretchen Diemer, MD; Frances Mae West, MD; Marie-Cecile Domecq, MLIS; Benjamin Hibbert, MD, PhD

This meta-analysis examines the comparative accuracy of clinical assessment alone versus clinical assessment plus focused cardiac ultrasonography for diagnosing left ventricular dysfunction or valvular disease in adults having cardiovascular evaluation.

Ann Intern Med. 2019;171(4):264-272. doi:10.7326/M19-1337

Holger J. Schünemann, MD, PhD, MSc; Donata Lerda, PhD; Nadya Dimitrova, PhD; Pablo Alonso-Coello, MD, PhD; Axel Gräwingholt, MD; Cecily Quinn, MD; Markus Follmann, MD, MPH, MSc; Robert Mansel, MD; Francesco Sardanelli, MD; Paolo Giorgi Rossi, PhD; Annette Lebeau, MD; Lennarth Nyström, PhD; Mireille Broeders, PhD; Lydia Ioannidou-Mouzaka, MD; Stephen W. Duffy, BSc, MSc, CStat; Bettina Borisch, MD; Patricia Fitzpatrick, MD; Solveig Hofvind, PhD; Xavier Castells, MD, PhD; Livia Giordano, MD; Sue Warman, MEd; Zuleika Saz-Parkinson, PhD; for the European Commission Initiative on Breast Cancer Contributor Group

The authors describe the rationale, methods, and process of the European Commission Initiative on Breast Cancer Screening and Diagnosis Guidelines.

Ann Intern Med. 2019;171(4):273-280. doi:10.7326/M18-3445

James Maroulis, JD, MAS; Tim Ken Mackey, MAS, PhD

States regulate health insurance, medical benefits, and the clinicians who provide care, and some states are exploring ways to use that power to fill coverage gaps that remain after passage of the Patient Protection and Affordable Care Act. The question is what states can accomplish, given that federal laws constrain what they can do with Medicare, Medicaid, and most employer-based insurance plans.

Ann Intern Med. 2019;171(4):281-282. doi:10.7326/M19-0509

Zuzanna Czernik, MD; Robert Chang, MD; Vineet Chopra, MD, MSc

The authors of this article ask if we can imagine a future in which the electronic medical record allows clinicians to spend more time with their patients while providing more effective care. How is that possible? We all know that the electronic medical record is the root cause of what's wrong with medicine today. Or, do we?

Ann Intern Med. 2019;171(4):283-284. doi:10.7326/M19-0589

Jeffrey L. Tokar, MD; Michael J. Bartel, MD

The editorialists discuss Takeuchi and colleagues' findings and outline remaining questions that must be answered to determine how best to balance the risks for bleeding with those for thromboembolism in patients receiving anticoagulants who are undergoing colonoscopy with possible polypectomy.

Ann Intern Med. 2019;171(4):285-286. doi:10.7326/M19-1708

Lisa H. Harris, MD, PhD; Vanessa Dalton, MD, MPH

The editorialists discuss Ralph and colleagues' findings and suggest that the health of women may depend not only on not having a reason to seek abortion but also on being able to receive abortion should the need arise.

Ann Intern Med. 2019;171(4):287-288. doi:10.7326/M19-1740

Kristian B. Filion, PhD; Oriana H. Yu, MD, MSc

Dave and colleagues examined the association between sodium–glucose cotransporter-2 (SGLT-2) inhibitors and risk for severe urinary tract infections in a real-world setting. The editorialists discuss the strengths and limitations of the findings and conclude that these data offer reassurance about the safety of SGLT-2 inhibitors with respect to severe urinary tract infections.

Ann Intern Med. 2019;171(4):289-290. doi:10.7326/M19-1950

Nir Flint, MD; Robert J. Siegel, MD

Marbach and colleagues reported a systematic review and meta-analysis of the comparative accuracy of focused cardiac ultrasonography examination using a hand-held device versus a clinical examination to assess left ventricular dysfunction and valvular heart disease. The editorialists discuss the promise and pitfalls of hand-held ultrasonography.

Ann Intern Med. 2019;171(4):291-292. doi:10.7326/M19-1918

Joshua D. Wallach, MS, PhD; Harlan M. Krumholz, MD, SM

The editorialists discuss Tatsioni and colleagues' findings and believe that failure to report clinical trial results should be considered academic misconduct at the individual and institutional levels.

Ann Intern Med. 2019;171(4):293-294. doi:10.7326/M19-1273

Diana Pi, MD

Months later, I hung up my white coat and walked out hugging a plastic crate containing everything I cared to keep from my professional life.

Ann Intern Med. 2019;171(4):295-296. doi:10.7326/M18-2911

Faith T. Fitzgerald, MD

Ann Intern Med. 2019;171(4):297. doi:10.7326/M18-3034

Ann Intern Med. 2019;171(4):300-301. doi:10.7326/M19-0440

Ann Intern Med. 2019;171(4):301-304. doi:10.7326/M18-3602

Ann Intern Med. 2019;171(4):304. doi:10.7326/L19-0209

Ann Intern Med. 2019;171(4):304-305. doi:10.7326/L19-0210

Ann Intern Med. 2019;171(4):305-306. doi:10.7326/L19-0211

Ann Intern Med. 2019;171(4):306. doi:10.7326/L19-0212

Ann Intern Med. 2019;171(4):306-307. doi:10.7326/L19-0214

Ann Intern Med. 2019;171(4):307. doi:10.7326/L19-0213

Ann Intern Med. 2019;171(4):307-308. doi:10.7326/L19-0215

Daniel Bosch

Ann Intern Med. 2019;171(4):298. doi:10.7326/M19-0948

Brian W. Christman, MD

Ann Intern Med. 2019;171(4):299. doi:10.7326/M19-1101

Ann Intern Med. 2019;171(4):JC14. doi:10.7326/ACPJ201908200-014

Ann Intern Med. 2019;171(4):JC15. doi:10.7326/ACPJ201908200-015

Ann Intern Med. 2019;171(4):JC16. doi:10.7326/ACPJ201908200-016

Ann Intern Med. 2019;171(4):JC17. doi:10.7326/ACPJ201908200-017

Ann Intern Med. 2019;171(4):JC18. doi:10.7326/ACPJ201908200-018

Ann Intern Med. 2019;171(4):JC19. doi:10.7326/ACPJ201908200-019

Ann Intern Med. 2019;171(4):JC20. doi:10.7326/ACPJ201908200-020

Ann Intern Med. 2019;171(4):JC21. doi:10.7326/ACPJ201908200-021

Ann Intern Med. 2019;171(4):JC22. doi:10.7326/ACPJ201908200-022

Ann Intern Med. 2019;171(4):JC23. doi:10.7326/ACPJ201908200-023

Geno J. Merli, MD; Howard H. Weitz, MD

Annals Consult Guys brings a new perspective to the art and science of medicine with lively discussion and analysis of real-world cases and situations. They address medically relevant topics—whether they be poignant, thought-provoking, or just plain entertaining.

Ann Intern Med. 2019;171(4):CG1. doi:10.7326/W18-0047

Darren B. Taichman, MD, PhD

Ann Intern Med. 2019;171(4):ED4. doi:10.7326/AWED201908200

David H. Wesorick, MD; Vineet Chopra, MD, MSc

Ann Intern Med. 2019;171(4):HO1. doi:10.7326/AWHO201908200

Scott A. Flanders, MD

Are the antibiotics that you prescribe at hospital discharge helping your patients or harming them? In this commentary, an expert discusses the optimal antibiotic duration for patients with pneumonia, emphasizing the benefits of less.

Ann Intern Med. 2019;171(4):HO2-HO3. doi:10.7326/M19-2235

Robert M. Centor, MD; Jeffrey A. Linder, MD, MPH

In this episode of Annals On Call, Dr. Centor discusses the diagnosis and treatment of pharyngitis in adolescents and young adults with Dr. Jeffrey Linder of Northwestern University.

Ann Intern Med. 2019;171(4):OC1. doi:10.7326/A19-0010

Michael Natter, MD

Progress Notes explores the everyday emotional, clinical, humorous, and ethical challenges of the medical residency training process. It appears monthly in Annals Graphic Medicine at Annals.org.

Ann Intern Med. 2019;171(4):W11-W12. doi:10.7326/G19-0051

Sarah Jiang, BS; Denys Bastov, BS; Archana Bharadwaj, BS, MPH; Eric R. Gross, MD, PhD

Annals Graphic Medicine brings together original graphic narratives, comics, animation/video, and other creative forms by those who provide or receive health care. They address medically relevant topics—whether they be poignant, thought-provoking, or just plain entertaining.

Ann Intern Med. 2019;171(4):W13-W26. doi:10.7326/G18-0025

Ann Intern Med. 2019;171(4):I-18. doi:10.7326/P19-0008

Ann Intern Med. 2019;171(4):I-11. doi:10.7326/P19-0009