Annals of Internal Medicine, tip sheet, September 7, 2004

Virtual and Optical Colonoscopy Both Detect Precancerous Lesions But Not Always the Same Lesions

A study of 1,233 adults who did not have signs of colon disease found that optical colonoscopy, the traditional method of viewing the colon and removing precancerous growths (polyps), and virtual colonoscopy, a new procedure using X-rays and computers to form three-dimensional images, missed between 10 percent to 14 percent of the polyps (Article, p. 352). The virtual colonoscopies also identified 'blind spots,' parts of the colon that optical colonoscopies can often miss. Because of the study design, all known lesions missed by one method were detected by the other. An editorial writer identifies four questions raised by the evolving technology of virtual colonoscopy (Editorial, p. 401). Until these are resolved, he says, virtual colonoscopy is not ready for "widespread use as a screening test or as a test to monitor polyp growth."

West Nile Fever Causes More and More Serious Symptoms Than Previously Thought

A study of 98 people identified as having West Nile fever found that the symptoms were more serious and lasted longer than previously described (Article, p. 360). West Nile fever is caused by infection by West Nile virus but is not accompanied by neurologic disease, such as meningitis or encephalitis. In the study, common symptoms were fatigue, muscle weakness, headache, difficulty concentrating, and fever. Almost a third of the patients were hospitalized from one to 56 days; 79 percent of those who attended school or work missed days because of the infection. The median time to recover was 60 days. Previous characterizations of West Nile fever were that its symptoms were mild and lasted three to six days.

Resynchronization of Heart Can Improve Quality of Life After Heart Attack But Is Not Cost-Effective

Two articles and an editorial, published online on August 17, 2004, appear in today's print e

Contact: Penny Fuller
American College of Physicians

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