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Current Opinion in Internal Medicine - Current Table Of Contents
Breastfeeding and allergies: time for a change in paradigm?.
Page: 539DOI: 10.1097/MCI.0b013e32831dae43Authors: Duncan, Joanne M; Sears, Malcolm R
New aspects in allergic contact dermatitis.
Page: 547DOI: 10.1097/MCI.0b013e32831dae50Authors: Mortz, Charlotte Gotthard; Andersen, Klaus Ejner
Contemporary approaches to the identification of athletes at risk for sudden cardiac death.
Page: 552DOI: 10.1097/MCI.0b013e32831daee4Authors: Drezner, Jonathan A
pubmed: 0003-4819
Recommended Adult Immunization Schedule: United States, 2012.
Recommended Adult Immunization Schedule: United States, 2012. Ann Intern Med. 2012 Jan 31; Authors: PMID: 22298576 [PubMed - as supplied by publisher]
Adult Immunization 2012: Politics, Process, and Progress.
Fryhofer SA Adult Immunization 2012: Politics, Process, and Progress. Ann Intern Med. 2012 Jan 31; Authors: Fryhofer SA PMID: 22298575 [PubMed - as supplied by publisher]
Archives of Internal Medicine current issue
On Motivating Patients: A Picture, Even If Worth a Thousand Words, Is Not Enough [Editorial]
O'Malley, P. G. Mon, 23 Jan 2012 12:41:30 -0800
Positive Affect and Self-affirmation Are Beneficial, but Do They Facilitate Maintenance of Health-Behavior Change?: Comment on "A Randomized Controlled Trial of Positive-Affect Intervention and Medication Adherence in Hypertensive African Americans" [Invited Commentary]
Williams, G. C., Niemiec, C. P. Mon, 23 Jan 2012 12:41:20 -0800
Impact of Carotid Plaque Screening on Smoking Cessation and Other Cardiovascular Risk Factors: A Randomized Controlled Trial [Original Investigation]
Rodondi, N., Collet, T.-H., Nanchen, D., Locatelli, I., Depairon, M., Aujesky, D., Bovet, P., Cornuz, J. Mon, 23 Jan 2012 12:41:11 -0800
Background Screening of peripheral atherosclerosis is increasingly used, but few trials have examined its clinical impact. We aimed to assess whether carotid plaque screening helps smokers to improve their health behaviors and cardiovascular risk factors. Methods We randomly assigned 536 smokers aged 40 to 70 years to carotid plaque ultrasonographic screening (US group) vs no screening (control group) in addition to individual counseling and nicotine replacement therapy for all participants. Smokers with at least 1 plaque received pictures of their plaques with a 7-minute structured explanation. The outcomes included biochemically validated smoking cessation at 12 months (primary outcome) and changes in cardiovascular risk factor levels and Framingham risk score. Results At baseline, participants (mean age, 51.1 years; 45.0% women) smoked an average of 20 cigarettes per day with a median duration of 32 years. The US group had a high prevalence of carotid plaques (57.9%). At 12 months, smoking cessation rates were high, but did not differ between the US and control groups (24.9% vs 22.1%; P = .45). In the US group, cessation rates did not differ according to the presence or absence of plaques. Control of cardiovascular risk factors (ie, blood pressure and low-density lipoprotein cholesterol and hemoglobin A1c levels in diabetic patients) and mean absolute risk change in Framingham risk score did not differ between the groups. The mean absolute risk change in Framingham risk score was +0.6 in the US group vs +0.3 in the control group (P = .56). Conclusion In smokers, carotid plaque screening performed in addition to thorough smoking cessation counseling is not associated with increased rates of smoking cessation or control of cardiovascular risk factors. Trial Registration clinicaltrials.gov Identifier: NCT00548665
Increasing Physical Activity in Patients With Asthma Through Positive Affect and Self-affirmation: A Randomized Trial [Original Investigation]
Mancuso, C. A., Choi, T. N., Westermann, H., Wenderoth, S., Hollenberg, J. P., Wells, M. T., Isen, A. M., Jobe, J. B., Allegrante, J. P., Charlson, M. E. Mon, 23 Jan 2012 12:40:59 -0800
Background Patients with asthma engage in less physical activity than peers without asthma. Protocols are needed to prudently increase physical activity in asthma patients. We evaluated whether an educational intervention enhanced with positive affect induction and self-affirmation was more effective than the educational protocol alone in increasing physical activity in asthma patients. Methods We conducted a randomized trial in New York City from September 28, 2004, through July 5, 2007; of 258 asthma patients, 252 completed the trial. At enrollment, control subjects completed a survey measuring energy expenditure, made a contract to increase physical activity, received a pedometer and an asthma workbook, and then underwent bimonthly follow-up telephone calls. Intervention patients received this protocol plus small gifts and instructions in fostering positive affect and self-affirmation. The main outcome was the within-patient change in energy expenditure in kilocalories per week from enrollment to 12 months with an intent-to-treat analysis. Results Mean (SD) energy expenditure at enrollment was 1767 (1686) kcal/wk among controls and 1860 (1633) kcal/wk among intervention patients (P = .65) and increased by 415 (95% CI, 76-754; P = .02) and 398 (95% CI, 145-652; P = .002) kcal/wk, respectively, with no difference between groups (P = .94). For both groups, energy expenditure was sustained through 12 months. No adverse events were attributed to the trial. In multivariate analysis, increased energy expenditure was associated with less social support, decreased depressive symptoms, more follow-up calls, use of the pedometer, fulfillment of the contract, and the intervention among patients who required urgent asthma care (all P < .10, 2-sided test). Conclusions A multiple-component protocol was effective in increasing physical activity in asthma patients, but an intervention to increase positive affect and self-affirmation was not effective within this protocol. The intervention may have had some benefit, however, in the subgroup of patients who required urgent asthma care during the trial. Trial Registration clinicaltrials.gov Identifier: NCT00195117
Randomized Controlled Trial of Positive Affect Induction to Promote Physical Activity After Percutaneous Coronary Intervention [Original Investigation]
Peterson, J. C., Charlson, M. E., Hoffman, Z., Wells, M. T., Wong, S.-C., Hollenberg, J. P., Jobe, J. B., Boschert, K. A., Isen, A. M., Allegrante, J. P. Mon, 23 Jan 2012 12:40:50 -0800
Background Within 1 year after percutaneous coronary intervention, more than 20% of patients experience new adverse events. Physical activity confers a 25% reduction in mortality; however, physical activity is widely underused. Thus, there is a need for more powerful behavioral interventions to promote physical activity. Our objective was to motivate patients to achieve an increase in expenditure of 336 kcal/wk or more at 12 months as assessed by the Paffenbarger Physical Activity and Exercise Index. Methods Two hundred forty-two patients were recruited immediately after percutaneous coronary intervention between October 2004 and October 2006. Patients were randomized to 1 of 2 groups. The patient education (PE) control group (n = 118) (1) received an educational workbook, (2) received a pedometer, and (3) set a behavioral contract for a physical activity goal. The positive affect/self-affirmation (PA) intervention group (n = 124) received the 3 PE control components pl
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Breastfeeding and allergies: time for a change in paradigm?.
Page: 539DOI: 10.1097/MCI.0b013e32831dae43Authors: Duncan, Joanne M; Sears, Malcolm R
New aspects in allergic contact dermatitis.
Page: 547DOI: 10.1097/MCI.0b013e32831dae50Authors: Mortz, Charlotte Gotthard; Andersen, Klaus Ejner
Contemporary approaches to the identification of athletes at risk for sudden cardiac death.
Page: 552DOI: 10.1097/MCI.0b013e32831daee4Authors: Drezner, Jonathan A
pubmed: 0003-4819
Recommended Adult Immunization Schedule: United States, 2012.
Recommended Adult Immunization Schedule: United States, 2012. Ann Intern Med. 2012 Jan 31; Authors: PMID: 22298576 [PubMed - as supplied by publisher]
Adult Immunization 2012: Politics, Process, and Progress.
Fryhofer SA Adult Immunization 2012: Politics, Process, and Progress. Ann Intern Med. 2012 Jan 31; Authors: Fryhofer SA PMID: 22298575 [PubMed - as supplied by publisher]
Archives of Internal Medicine current issue
On Motivating Patients: A Picture, Even If Worth a Thousand Words, Is Not Enough [Editorial]
O'Malley, P. G. Mon, 23 Jan 2012 12:41:30 -0800
Positive Affect and Self-affirmation Are Beneficial, but Do They Facilitate Maintenance of Health-Behavior Change?: Comment on "A Randomized Controlled Trial of Positive-Affect Intervention and Medication Adherence in Hypertensive African Americans" [Invited Commentary]
Williams, G. C., Niemiec, C. P. Mon, 23 Jan 2012 12:41:20 -0800
Impact of Carotid Plaque Screening on Smoking Cessation and Other Cardiovascular Risk Factors: A Randomized Controlled Trial [Original Investigation]
Rodondi, N., Collet, T.-H., Nanchen, D., Locatelli, I., Depairon, M., Aujesky, D., Bovet, P., Cornuz, J. Mon, 23 Jan 2012 12:41:11 -0800
Background Screening of peripheral atherosclerosis is increasingly used, but few trials have examined its clinical impact. We aimed to assess whether carotid plaque screening helps smokers to improve their health behaviors and cardiovascular risk factors. Methods We randomly assigned 536 smokers aged 40 to 70 years to carotid plaque ultrasonographic screening (US group) vs no screening (control group) in addition to individual counseling and nicotine replacement therapy for all participants. Smokers with at least 1 plaque received pictures of their plaques with a 7-minute structured explanation. The outcomes included biochemically validated smoking cessation at 12 months (primary outcome) and changes in cardiovascular risk factor levels and Framingham risk score. Results At baseline, participants (mean age, 51.1 years; 45.0% women) smoked an average of 20 cigarettes per day with a median duration of 32 years. The US group had a high prevalence of carotid plaques (57.9%). At 12 months, smoking cessation rates were high, but did not differ between the US and control groups (24.9% vs 22.1%; P = .45). In the US group, cessation rates did not differ according to the presence or absence of plaques. Control of cardiovascular risk factors (ie, blood pressure and low-density lipoprotein cholesterol and hemoglobin A1c levels in diabetic patients) and mean absolute risk change in Framingham risk score did not differ between the groups. The mean absolute risk change in Framingham risk score was +0.6 in the US group vs +0.3 in the control group (P = .56). Conclusion In smokers, carotid plaque screening performed in addition to thorough smoking cessation counseling is not associated with increased rates of smoking cessation or control of cardiovascular risk factors. Trial Registration clinicaltrials.gov Identifier: NCT00548665
Increasing Physical Activity in Patients With Asthma Through Positive Affect and Self-affirmation: A Randomized Trial [Original Investigation]
Mancuso, C. A., Choi, T. N., Westermann, H., Wenderoth, S., Hollenberg, J. P., Wells, M. T., Isen, A. M., Jobe, J. B., Allegrante, J. P., Charlson, M. E. Mon, 23 Jan 2012 12:40:59 -0800
Background Patients with asthma engage in less physical activity than peers without asthma. Protocols are needed to prudently increase physical activity in asthma patients. We evaluated whether an educational intervention enhanced with positive affect induction and self-affirmation was more effective than the educational protocol alone in increasing physical activity in asthma patients. Methods We conducted a randomized trial in New York City from September 28, 2004, through July 5, 2007; of 258 asthma patients, 252 completed the trial. At enrollment, control subjects completed a survey measuring energy expenditure, made a contract to increase physical activity, received a pedometer and an asthma workbook, and then underwent bimonthly follow-up telephone calls. Intervention patients received this protocol plus small gifts and instructions in fostering positive affect and self-affirmation. The main outcome was the within-patient change in energy expenditure in kilocalories per week from enrollment to 12 months with an intent-to-treat analysis. Results Mean (SD) energy expenditure at enrollment was 1767 (1686) kcal/wk among controls and 1860 (1633) kcal/wk among intervention patients (P = .65) and increased by 415 (95% CI, 76-754; P = .02) and 398 (95% CI, 145-652; P = .002) kcal/wk, respectively, with no difference between groups (P = .94). For both groups, energy expenditure was sustained through 12 months. No adverse events were attributed to the trial. In multivariate analysis, increased energy expenditure was associated with less social support, decreased depressive symptoms, more follow-up calls, use of the pedometer, fulfillment of the contract, and the intervention among patients who required urgent asthma care (all P < .10, 2-sided test). Conclusions A multiple-component protocol was effective in increasing physical activity in asthma patients, but an intervention to increase positive affect and self-affirmation was not effective within this protocol. The intervention may have had some benefit, however, in the subgroup of patients who required urgent asthma care during the trial. Trial Registration clinicaltrials.gov Identifier: NCT00195117
Randomized Controlled Trial of Positive Affect Induction to Promote Physical Activity After Percutaneous Coronary Intervention [Original Investigation]
Peterson, J. C., Charlson, M. E., Hoffman, Z., Wells, M. T., Wong, S.-C., Hollenberg, J. P., Jobe, J. B., Boschert, K. A., Isen, A. M., Allegrante, J. P. Mon, 23 Jan 2012 12:40:50 -0800
Background Within 1 year after percutaneous coronary intervention, more than 20% of patients experience new adverse events. Physical activity confers a 25% reduction in mortality; however, physical activity is widely underused. Thus, there is a need for more powerful behavioral interventions to promote physical activity. Our objective was to motivate patients to achieve an increase in expenditure of 336 kcal/wk or more at 12 months as assessed by the Paffenbarger Physical Activity and Exercise Index. Methods Two hundred forty-two patients were recruited immediately after percutaneous coronary intervention between October 2004 and October 2006. Patients were randomized to 1 of 2 groups. The patient education (PE) control group (n = 118) (1) received an educational workbook, (2) received a pedometer, and (3) set a behavioral contract for a physical activity goal. The positive affect/self-affirmation (PA) intervention group (n = 124) received the 3 PE control components pl
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