March/April 2005 Annals of Family Medicine tip sheet
...High-protein diets that include a lot of iron-containing foods, such as the increasingly popular Atkins diet, may not be the best choice for everybody, according to a new study out of the Medical University of South Carolina. Analyzing population-based data from U.S. National Health and Nutrition Examination Surveys, Mainous and colleagues found that people with elevated levels of serum trans...Annals of Internal Medicine tip sheet for March 15, 2005
...--It's Not Necessarily the Carbs or Loss of Fluids. It's Fewer Calories...... A new three-week in-hospital study of ten obese volunteers with mild type 2 diabetes mellitus compared a usual diet with a very low-carbohydrate diet (Article, p. 403). ...... During the first study week, participants ate about 3,000 calories and 300 grams of carbohydrates per day and remained at entry weight..........Feb. 15, 2005, Annals of Internal Medicine tip sheet
...... In a new study of 5,887 middle-aged smokers with mild lung disease, those who were randomly assigned to a quit-smoking program had a lower death rate than those assigned to usual care even though only 21.7 percent of them actually quit smoking (Article, p. 233)....... The annual death rates were 8.8 per 1000 patients in the quit-smoking program and 10.4 per 1000 in the usual care group. T...Feb. 1, 2005, Annals of Internal Medicine tip sheet
...... The U.S. Preventive Services Task Force recommends a one-time ultrasound examination to screen for abdominal aortic aneurysm for men between the ages of 65 and 75 who are or have been smokers (Clinical Guidelines, p. 198 and 203)....... This is the first time the Task Force has recommended screening for abdominal aortic aneurysm....... Estimates indicate that between 59 percent and 83 per...January/February Annals of Family Medicine tip sheet
...Contrary to common perception, injuries attributable to alcohol consumption are more likely to be associated with an occasion of alcohol consumption than with alcohol dependence. In this population-based study of 2,517 patients admitted to three emergency departments between 1998 and 2000, most alcohol-associated injuries occurred in persons who had consumed alcohol during the six hours befo...Tip sheet Annals of Internal Medicine, Jan. 18, 2005
...... Two articles and an editorial in the Jan. 18, 2005, Annals of Internal Medicine discuss the fecal occult blood test (FOBT), a test for blood in the stool. Current screening recommendations are that adults over age 50 should take a six-sample FOBT test at home and return the stool samples to their physicians for interpretation. Positive tests should be followed up with a colonoscopy. Unfor...Tip sheet Annals of Internal Medicine, Jan. 4, 2005
... ...(Review, p. 56.) (NOTE: This study is the subject of a video news release; call 215-351-2514 for satellite coordinates.) ...... ... 2. Heavy Drinking is Associated with Risk for Stroke... ...A new analysis of data from a study of the nutrition habits and illnesses of 38,156 men found that heavy alcohol drinking was associated with increased risk for ischemic stroke (Article, p. 11). Lig...Annals of Internal Medicine, tip sheet, Dec. 21, 2004
...... examine several complementary and alternative medicine (CAM) treatments for very common medical conditions....... A study of 570 people in a randomized, controlled trial comparing acupuncture with sham acupuncture and education to treat osteoarthritis of the knee found that acupuncture, used in addition to regular arthritis care, is effective (Article, p. 901)....... A second study of 13...Dec. 7 tip sheet Annals of Internal Medicine
...... A study being released early online found that the COX-2 inhibitor rofecoxib (brand name Vioxx) had 2.72 higher odds for heart attack when compared with another COX-2 inhibitor, celecoxib (brand name Celebrex). ...... Rofecoxib was also associated with higher odds for heart attack compared with older NANSAIDs (non-selective non-aspirin non-steroidal anti-inflammatory drugs). It was not cl...November/December 2004 Annals of Family Medicine tip sheet
...A report published today as an online supplement to the November/December 2004 issue projects that implementation of the New Model of care recommended in the recently released "Future of Family Medicine" report would enhance the financial viability of family medicine practices, many of whose survival is endangered by their place on the front lines of a failing health care system. The report...Annals of Internal Medicine, tip sheet, Nov. 16, 2004
...... Researchers identified articles on health disparities in 10 leading health journals in 2002 and 2003 and selected 11 with potential to lessen these disparities (Update, p. 805)....... They divided the must-read articles into studies that documented disparities and studies that explained the disparities at the patient, physician and system levels. ...... Unfortunately, the researchers say...Annals of Internal Medicine tip sheet for Nov. 2, 2004
Annals of Internal Medicine is published by the American College of Physicians, an organization of 116,000 internal medicine physicians and medical students. These highlights are not intended to substitute for articles as sources of information. For an embargoed copy of an article, call 1-800-523-1546, ext. 2656, or 215-351-2656. Leave fax or e-mail and article topics. ...... ...... A study of t...Annals of Internal Medicine tip sheet for Oct. 19, 2004
...... A six-week study of 196 men with moderately severe symptoms of chronic prostate/chronic pelvic pain (CP/CPPS) found that neither of two commonly prescribed drugs, ciprofloxacin, an antibiotic, or tamsulosin, an a-receptor blocker, successfully relieved symptoms (Article, p. 581)....... CP/CPPS is a common disorder in men, characterized primarily by pain in the pelvic region and sometimes...Annals of Internal Medicine, tip sheet, September 7, 2004
...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 ident...July/August 2004 Annals of Family Medicine tip sheet
...Counter to the prevailing perception that adverse drug events and surgical mishaps are the primary causes of medical errors, this qualitative study of 38 patients suggests that breakdowns in the clinician-patient relationship (37 percent) and access to clinicians (29 percent) may be more prominent. When asked about problems they experienced in the primary care office setting, patients were m...Annals of Internal Medicine tip sheet for July 6, 2004
...... American ginseng, a widely used herbal supplement, reduced the anticoagulant effect of warfarin, a commonly prescribed blood thinner (Article, p. 23). At the end of the four-week study involving 20 young, healthy volunteers, those who took ginseng had lower blood levels of warfarin and less of an effect on blood clotting than those volunteers who were given a placebo pill.... ...Authors s...Annals of Internal Medicine, tip sheet, June 1, 2004
Early Use of Statins in Hospitalized Patients May Benefit Some... ...An observational study of 19,537 patients admitted to 94 hospitals in 14 countries found that people who used cholesterol-lowering drugs called statins before admission had better outcomes than patients who never took statins. This benefit occurred only if patients continued statins in the hospital (Article. p. 857). Researcher...May/June 2004 Annals of Family Medicine tip sheet
...Asserting that the potential harms outweigh the potential benefits, the U.S. Preventive Services Task Force recommends against routine screening for ovarian cancer. The new recommendation statement reflects no change from its 1996 recommendation against routine ovarian cancer screening. The Task Force found no existing evidence that any screening test, including screening with serum CA-125,...Annals of Internal Medicine, tip sheet, May 18, 2004
... ...Two randomized trials in this issue of Annals of Internal Medicine compared low-carbohydrate diets with low-fat diets and found that people on the low-carb diets had improved triglyceride levels and slightly improved HDL ('good') cholesterol levels. Changes in LDL ('bad') cholesterol levels were not significant (Article, p. 769; Article, p. 778). ......One study followed 120 overweight pe...Annals of Internal Medicine, tip sheet, May 4, 2004
Screening People with Hypertension for Diabetes Is Cost-Effective...But Universal Screening for Diabetes Is Not ... ...... ... ...... ...Three-quarters of women over age 70 in a telephone survey reported having a had recent mammography, Pap test, or both, accordi...Annals of Internal Medicine, tip sheet, April 20, 2004
... ...... ... ... A study of primary data from eight studies in five countries found that people who drank more than 45 grams of alcohol per day, or more than three average-size drinks, had a slightly higher risk for colorectal cancer than those who drank less or no alcohol (Article, p. 603). The study found no relationship between the type of alcoholic beverage people drank...Annals of Internal Medicine, tip sheet, April 6, 2004
... A new study of 521 people with newly diagnosed Alzheimer disease found that the median survival period was 4.2 years for men and 5.7 years for women (Article, p. 501), which is about half as long as people of similar age in the U.S. population would survive. The study found that the severity of cognitive impairment was strongly associated with decreased survival. Walking disturbances, falli...March/April 2004 Annals of Family Medicine tip sheet
... ...Analyzing population-based data from U.S. National Health and Nutrition Examination Surveys, Mainous and colleagues found that elevated levels of serum transferrin saturation, an indicator of a predisposition for iron overload, were associated with a significantly higher risk of death from all causes. The authors point out that a substantial proportion of adults in the United Stat...Annals of Internal Medicine, tip sheet, March 16, 2004
...People who aren't at high risk for hepatitis C infection do not need to be screened for the disease, according to a new recommendation from the U.S. Preventive Services Task Force (Clinical Guidelines, p. 462 and p. 465). In addition, the Task Force concluded that the scientific evidence that screening improves health is not strong enough to screen people who are at high risk for contracting...March 2, 2004, Annals of Internal Medicine tip sheet
...... Using antibacterial products, such as soaps, household cleaners and laundry detergents, does not reduce the risk for infectious disease symptoms in households of healthy individuals, a new study finds (Article, p. 321). Researchers studied 224 urban households in which one group was given household cleaning and personal hygiene products that contained antibacterial ingredients and the sec...Annals of Internal Medicine, tip sheet, February 17, 2004
......The U.S. Preventive Services Task Force has issued new recommendations for screening asymptomatic (apparently healthy) people for heart disease. The group does not recommend EKG, treadmill tests and CT scans to screen people at low risk for heart disease. It says that evidence is insufficient to recommend for or against using these three tests to screen for heart disease in asymptomatic ad...Annals of Internal Medicine tip sheet February 3, 2004
... ...A study of 27,077 women found that those who took higher doses of aspirin seem to have lower risk for developing adenomas (a type of polyp that can become colorectal cancer) than those who reported never using or rarely using aspirin. The women had no known history of colon disease at the start of the study and had a colonoscopy or sigmoidoscopy between 1980 and 1998. Overall, 1,368 ca...Jan/Feb 2004 Annals of Family Medicine tip sheet
... Asserting that the prevailing model for palliative care of the elderly is fundamentally flawed and ill-suited for older patients suffering from slowly progressive chronic illness, four researchers from the University of California Davis School of Medicine have proposed a new framework for palliative care the TLC model. The new model is named for its five defining characteristics timely,...Annals of Internal Medicine tip sheet for Jan. 20, 2004
...... The U.S. Preventive Services Task Force did not find sufficiently strong evidence to make a recommendation for or against screening people with no thyroid symptoms for thyroid disease (Clinical Guidelines, p. 125; Background Evidence Summary, p. 128). The USPSTF evaluates published research and makes recommendations about preventive health care. The Task Force says that physicians should...Annals of Internal Medicine, tip sheet, January 6, 2004
...Men and women who drank more coffee and other caffeinated beverages were less likely to develop type 2 diabetes than those who drank few or no caffeinated beverages (Article, p.1). Researchers based their conclusions on data from a study of more than 126,000 men and women who reported their intake of coffee and other caffeinated beverages every two to four years over a period of 12 to 18 year...Annals of Internal Medicine tip sheet December 16, 2003
... The American Academy of Family Physicians and the American College of Physicians released joint guidelines to manage new-onset atrial fibrillation, a common arrhythmia (irregular heartbeat) that occurs most often in older adults (Guidelines, pp. 1009-1017; Background Evidence Paper, pp. 1018-1033). According to the new guidelines, control of heart rate (not heart rhythm) with chronic antico...Annals of Internal Medicine, tip sheet, December 2, 2003
...... The U.S. Preventive Services Task Force recommends that clinicians screen all adults for obesity and offer obese patients intensive counseling and behavioral interventions to lose weight (Clinical Guidelines, p. 930). The Task Force recommends using body mass index to determine weight category. A BMI between 25 and 29.9 is considered overweight and a BMI over 30 is considered obese. BMI i...Nov/Dec 2003 Annals of Family Medicine tip sheet
The November/December 2003 issue of focuses on cervical cancer screening, a preventive practice that has contributed to the significant decline in the number deaths from cervical cancer over the past several decades. According to the American Cancer Society, between 1955 and 1992, the number of cervical cancer deaths in the United States dropped by 74 percent, in large part due to the increased...Annals of Internal Medicine, tip sheet, November 18, 2003
49% of American Physicians Support National Health Insurance, Study Finds... ...A substantial proportion of U.S. doctors support national health insurance, a new study finds (Article, p. 795). Among 1,650 primary care physicians, surgeons, and specialists responding to a survey, 49 percent supported governmental legislation to establish universal national health insurance, and 40 percent opposed...Annals of Internal Medicine, tip sheet, November 4, 2003
...... Vulnerable older adults estimated at one-third of all adults over 65 are getting generally good treatment for medical conditions, such as heart disease, stroke and diabetes, a new study finds (Article, p. 740). But care for important geriatric conditions (e.g., bedsores, falls, incontinence) and end-of-life care need improvement. Vigilance and treatment for such conditions help the elde...Annals of Internal Medicine, tip sheet, October 21, 2003
Patients May Not Fare Best With Docs or Hospitals That Most Frequently Perform the Surgery... ...Many studies have suggested that patients who have surgery at hospitals that perform a large number of a specific surgery do better than patients who have the same surgery at low-volume hospitals. But two studies in the November 21 Annals of Internal Medicine find that simple calculations of volume v...Annals of Internal Medicine, tip sheet, October 7, 2003
...Almost 40 percent of 626 patients in pulmonary and lung-cancer clinics in five locations believed that exposure of lung cancer to air at the time of cancer surgery promotes spread of the cancer (Article, p. 558). The survey participants were predominantly middle-aged or elderly men using a voluntary, self-administered questionnaire. This belief was more common among those with lower incomes,...Sept/Oct Annals of Family Medicine tip sheet
The September/October 2003 issue of takes an up-close look at continuity of care the ongoing relationship between a patient and a physician. This central tenet of primary care is being undermined by the current organizational and financial restructuring of the U.S. health-care system. As the authors point out, the systemic changes in American health care have hampered patients' and clinicians...... Two herbal weight-loss products manufactured in China and sold in Japan and on the Internet caused liver injury to 12 patients taking the product, according to a new study (Brief Communication, p. 488). One patient died and another needed a liver transplant; the remaining patients recovered after stopping the products, Chaso and Onshido. Both were advertised by their manufacturers as contain...Treating Older Adults for Flu Is Cost-Effective,...But Preventing It With a Yearly Flu Shot Is Better ...Click for a news release. This article is the subject of a video news release. Call for coordinates.... ...... ... A study of recorded symptoms of 28 patients with inhalational anthrax and 4,694 patients with viral respiratory illnesses found that fever and cough were common in both infecti...