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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
Metformin stinks, literally.
Pelletier AL, Butler AM, Gillies RA, May JR Related Articles Metformin stinks, literally. Ann Intern Med. 2010 Feb 16;152(4):267-8 Authors: Pelletier AL, Butler AM, Gillies RA, May JR PMID: 20157150 [PubMed - indexed for MEDLINE]
Comparing costs and quality of care at retail clinics with those of other medical settings.
Kochar R Related Articles Comparing costs and quality of care at retail clinics with those of other medical settings. Ann Intern Med. 2010 Feb 16;152(4):266; author reply 267 Authors: Kochar R PMID: 20157149 [PubMed - indexed for MEDLINE]
Comparing costs and quality of care at retail clinics with those of other medical settings.
Young RA Related Articles Comparing costs and quality of care at retail clinics with those of other medical settings. Ann Intern Med. 2010 Feb 16;152(4):266; author reply 267 Authors: Young RA PMID: 20157148 [PubMed - indexed for MEDLINE]
Comparing costs and quality of care at retail clinics with those of other medical settings.
Johnson JR Related Articles Comparing costs and quality of care at retail clinics with those of other medical settings. Ann Intern Med. 2010 Feb 16;152(4):266-7; author reply 267 Authors: Johnson JR PMID: 20157147 [PubMed - indexed for MEDLINE]
The net clinical benefit of warfarin anticoagulation in atrial fibrillation.
Budhraja V Related Articles The net clinical benefit of warfarin anticoagulation in atrial fibrillation. Ann Intern Med. 2010 Feb 16;152(4):265 Authors: Budhraja V PMID: 20157146 [PubMed - indexed for MEDLINE]
The net clinical benefit of warfarin anticoagulation in atrial fibrillation.
Bussey H Related Articles The net clinical benefit of warfarin anticoagulation in atrial fibrillation. Ann Intern Med. 2010 Feb 16;152(4):264-5; author reply 265 Authors: Bussey H PMID: 20157144 [PubMed - indexed for MEDLINE]
Archives of Internal Medicine current issue
The Value of New Chemotherapeutic Agents for Metastatic Colorectal Cancer [Original Investigation]
Howard, D. H., Kauh, J., Lipscomb, J.Background New chemotherapeutic agents for patients diagnosed with metastatic colorectal cancer have been singled out as examples of high-cost/low-value medical care. We measure trends in life expectancy and lifetime medical costs in this patient population between January 1, 1995, and December 31, 2005.Methods Using the Surveillance, Epidemiology, and End Results–Medicare database, we constructed a sample of 4665 patients aged 66 and older diagnosed with metastatic colorectal cancer between January 1, 1995, and December 31, 2005, who received chemotherapeutic agents. We estimated life expectancy and lifetime medical costs based on observed short-term survival rates and costs.Results Life expectancy increased by 6.8 months and lifetime costs by $37 100 (2006 dollars). The implied cost per life-year gained is $66 200 (95% confidence interval, $48 100-$84 200). After discounting life-years and costs and adjusting for patients' health utility and out-of-pocket payments, the cost per quality-adjusted life-year gained is $99 100 (95% confidence interval, $72 300-$125 900).Conclusions New chemotherapeutic agents are associated with improvements in survival time but also with substantial costs. The cost-effectiveness ratio for these drugs as a group is below commonly cited estimates of the willingness-to-pay for a life-year. However, open-ended coverage policies for new chemotherapeutic agents may prove difficult to sustain as costs continue to rise.Published online March 16, 2010 (doi:10.1001/archinternmed.2010.36).
Timely Care After an Abnormal Mammogram Among Low-Income Women in a Public Breast Cancer Screening Program [Original Investigation]
Lobb, R., Allen, J. D., Emmons, K. M., Ayanian, J. Z.Background Since 1990, the National Breast and Cervical Cancer Early Detection Program (BCCEDP) has funded breast cancer screening and diagnostic services for low-income, underinsured women. Case management was implemented in 2001 to address barriers to follow-up after an abnormal mammogram, and free treatment was introduced in 2004. However, the effect of these policies on timeliness of care has not been empirically evaluated.Methods Among 2252 BCCEDP participants in Massachusetts during 1998 through 2007, we conducted a time-to-event analysis with prepolicy-postpolicy comparisons to examine associations of case management and free treatment with diagnostic and treatment delays (>60 days and >90 days, respectively) after an abnormal mammogram.Results The proportion of women experiencing a diagnostic delay decreased from 33% to 23% after the introduction of case management (P < .001), with a significant reduction in the adjusted risk of diagnostic delay (relative risk [RR], 0.65; 95% confidence interval [CI], 0.53-0.79) that did not differ by race and ethnicity. However, case management was not associated with changes in treatment delay (RR, 0.93; 95% CI, 0.80-1.10). Free treatment was not associated with changes in the adjusted risk of diagnostic delay (RR, 0.61; 95% CI, 0.33-1.14) or treatment delay (RR, 0.77; 95% CI, 0.43-1.38) beyond improvements associated with case management.Conclusions Case management to assist women in overcoming logistic and psychosocial barriers to care may improve time to diagnosis among low-income women who receive free breast cancer screening and diagnostic services. Programs that provide services to coordinate care, in addition to free screening and diagnostic tests, may improve population health.Published online March 16, 2010 (doi:10.1001/archinternmed.2010.22).
Cancer and the Media: How Does the News Report on Treatment and Outcomes? [Original Investigation]
Fishman, J., Ten Have, T., Casarett, D.Background Cancer receives a great deal of news media attention. Although approximately half of all US patients with cancer die of their illness or of related complications, it is unknown whether reports in the news media reflect this reality.Methods To determine how cancer news coverage reports about cancer care and outcomes, we conducted a content analysis of US cancer news reporting in 8 large-readership newspapers and 5 national magazines. Trained coders determined the proportion of articles reporting about cancer survival, cancer death and dying, aggressive cancer treatment, cancer treatment failure, adverse events of cancer treatment, and end-of-life palliative or hospice care.Results Of 436 articles about cancer, 140 (32.1%; 95% confidence interval [CI], 28%-37%) focused on survival and only 33 (7.6 %; 5%-10%) focused on death and dying (P < .001, 2 test). Only 57 articles (13.1%; 10%-17%) reported that aggressive cancer treatments can fail, and 131 (30.0%; 26%-35%) reported that aggressive treatments can result in adverse events. Although most articles (249 of 436 [57.1%]; 95% CI, 52%-62%) discussed aggressive treatments exclusively, almost none (2 of 436; [0.5%]; 0%-2%) discussed end-of-life palliative or hospice care exclusively (P < .001, 2 test), and only a few (11 of 436 [2.5%]; 1%-6%) discussed aggressive treatment and end-of-life care.Conclusions News reports about cancer frequently discuss aggressive treatment and survival but rarely discuss treatment failure, adverse events, end-of-life care, or death. These portrayals of cancer care in the news media may give patients an inappropriately optimistic view of cancer treatment, outcomes, and prognosis.Published online March 16, 2010 (doi:10.1001/archinternmed.2010.11).
First Physical [Editorial]
Redberg, R. F.
About This Journal [About This Journal]
In This Issue of Archives of Internal Medicine [In This Issue of Archives of Internal Medicine]
Patient-Centered Comparative Effectiveness Research: Essential for High-Quality Care [Commentary]
Slutsky, J. R., Clancy, C. M.
Food Surcharges and Subsidies: Putting Your Money Where Your Mouth Is [Editorial]
Katz, M. H., Bhatia, R.
Changing the Culture of Nursing Homes: The Physician's Role [Editorial]
Johnson, M.
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
How to break the vicious circle of antibiotic resistances?.
Page: 560DOI: 10.1097/MCI.0b013e32831dabd1Authors: Leone, Marc; Martin, Claude
Benefits of high-protein weight loss diets: enough evidence for practice?.
Page: 566DOI: 10.1097/MCI.0b013e32831daebdAuthors: Brehm, Bonnie J a; D'Alessio, David A b
Chronic pancreatitis.
Page: 572DOI: 10.1097/MCI.0b013e32831daddaAuthors: Conwell, Darwin L; Banks, Peter A
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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
Metformin stinks, literally.
Pelletier AL, Butler AM, Gillies RA, May JR Related Articles Metformin stinks, literally. Ann Intern Med. 2010 Feb 16;152(4):267-8 Authors: Pelletier AL, Butler AM, Gillies RA, May JR PMID: 20157150 [PubMed - indexed for MEDLINE]
Comparing costs and quality of care at retail clinics with those of other medical settings.
Kochar R Related Articles Comparing costs and quality of care at retail clinics with those of other medical settings. Ann Intern Med. 2010 Feb 16;152(4):266; author reply 267 Authors: Kochar R PMID: 20157149 [PubMed - indexed for MEDLINE]
Comparing costs and quality of care at retail clinics with those of other medical settings.
Young RA Related Articles Comparing costs and quality of care at retail clinics with those of other medical settings. Ann Intern Med. 2010 Feb 16;152(4):266; author reply 267 Authors: Young RA PMID: 20157148 [PubMed - indexed for MEDLINE]
Comparing costs and quality of care at retail clinics with those of other medical settings.
Johnson JR Related Articles Comparing costs and quality of care at retail clinics with those of other medical settings. Ann Intern Med. 2010 Feb 16;152(4):266-7; author reply 267 Authors: Johnson JR PMID: 20157147 [PubMed - indexed for MEDLINE]
The net clinical benefit of warfarin anticoagulation in atrial fibrillation.
Budhraja V Related Articles The net clinical benefit of warfarin anticoagulation in atrial fibrillation. Ann Intern Med. 2010 Feb 16;152(4):265 Authors: Budhraja V PMID: 20157146 [PubMed - indexed for MEDLINE]
The net clinical benefit of warfarin anticoagulation in atrial fibrillation.
Bussey H Related Articles The net clinical benefit of warfarin anticoagulation in atrial fibrillation. Ann Intern Med. 2010 Feb 16;152(4):264-5; author reply 265 Authors: Bussey H PMID: 20157144 [PubMed - indexed for MEDLINE]
Archives of Internal Medicine current issue
The Value of New Chemotherapeutic Agents for Metastatic Colorectal Cancer [Original Investigation]
Howard, D. H., Kauh, J., Lipscomb, J.Background New chemotherapeutic agents for patients diagnosed with metastatic colorectal cancer have been singled out as examples of high-cost/low-value medical care. We measure trends in life expectancy and lifetime medical costs in this patient population between January 1, 1995, and December 31, 2005.Methods Using the Surveillance, Epidemiology, and End Results–Medicare database, we constructed a sample of 4665 patients aged 66 and older diagnosed with metastatic colorectal cancer between January 1, 1995, and December 31, 2005, who received chemotherapeutic agents. We estimated life expectancy and lifetime medical costs based on observed short-term survival rates and costs.Results Life expectancy increased by 6.8 months and lifetime costs by $37 100 (2006 dollars). The implied cost per life-year gained is $66 200 (95% confidence interval, $48 100-$84 200). After discounting life-years and costs and adjusting for patients' health utility and out-of-pocket payments, the cost per quality-adjusted life-year gained is $99 100 (95% confidence interval, $72 300-$125 900).Conclusions New chemotherapeutic agents are associated with improvements in survival time but also with substantial costs. The cost-effectiveness ratio for these drugs as a group is below commonly cited estimates of the willingness-to-pay for a life-year. However, open-ended coverage policies for new chemotherapeutic agents may prove difficult to sustain as costs continue to rise.Published online March 16, 2010 (doi:10.1001/archinternmed.2010.36).
Timely Care After an Abnormal Mammogram Among Low-Income Women in a Public Breast Cancer Screening Program [Original Investigation]
Lobb, R., Allen, J. D., Emmons, K. M., Ayanian, J. Z.Background Since 1990, the National Breast and Cervical Cancer Early Detection Program (BCCEDP) has funded breast cancer screening and diagnostic services for low-income, underinsured women. Case management was implemented in 2001 to address barriers to follow-up after an abnormal mammogram, and free treatment was introduced in 2004. However, the effect of these policies on timeliness of care has not been empirically evaluated.Methods Among 2252 BCCEDP participants in Massachusetts during 1998 through 2007, we conducted a time-to-event analysis with prepolicy-postpolicy comparisons to examine associations of case management and free treatment with diagnostic and treatment delays (>60 days and >90 days, respectively) after an abnormal mammogram.Results The proportion of women experiencing a diagnostic delay decreased from 33% to 23% after the introduction of case management (P < .001), with a significant reduction in the adjusted risk of diagnostic delay (relative risk [RR], 0.65; 95% confidence interval [CI], 0.53-0.79) that did not differ by race and ethnicity. However, case management was not associated with changes in treatment delay (RR, 0.93; 95% CI, 0.80-1.10). Free treatment was not associated with changes in the adjusted risk of diagnostic delay (RR, 0.61; 95% CI, 0.33-1.14) or treatment delay (RR, 0.77; 95% CI, 0.43-1.38) beyond improvements associated with case management.Conclusions Case management to assist women in overcoming logistic and psychosocial barriers to care may improve time to diagnosis among low-income women who receive free breast cancer screening and diagnostic services. Programs that provide services to coordinate care, in addition to free screening and diagnostic tests, may improve population health.Published online March 16, 2010 (doi:10.1001/archinternmed.2010.22).
Cancer and the Media: How Does the News Report on Treatment and Outcomes? [Original Investigation]
Fishman, J., Ten Have, T., Casarett, D.Background Cancer receives a great deal of news media attention. Although approximately half of all US patients with cancer die of their illness or of related complications, it is unknown whether reports in the news media reflect this reality.Methods To determine how cancer news coverage reports about cancer care and outcomes, we conducted a content analysis of US cancer news reporting in 8 large-readership newspapers and 5 national magazines. Trained coders determined the proportion of articles reporting about cancer survival, cancer death and dying, aggressive cancer treatment, cancer treatment failure, adverse events of cancer treatment, and end-of-life palliative or hospice care.Results Of 436 articles about cancer, 140 (32.1%; 95% confidence interval [CI], 28%-37%) focused on survival and only 33 (7.6 %; 5%-10%) focused on death and dying (P < .001, 2 test). Only 57 articles (13.1%; 10%-17%) reported that aggressive cancer treatments can fail, and 131 (30.0%; 26%-35%) reported that aggressive treatments can result in adverse events. Although most articles (249 of 436 [57.1%]; 95% CI, 52%-62%) discussed aggressive treatments exclusively, almost none (2 of 436; [0.5%]; 0%-2%) discussed end-of-life palliative or hospice care exclusively (P < .001, 2 test), and only a few (11 of 436 [2.5%]; 1%-6%) discussed aggressive treatment and end-of-life care.Conclusions News reports about cancer frequently discuss aggressive treatment and survival but rarely discuss treatment failure, adverse events, end-of-life care, or death. These portrayals of cancer care in the news media may give patients an inappropriately optimistic view of cancer treatment, outcomes, and prognosis.Published online March 16, 2010 (doi:10.1001/archinternmed.2010.11).
First Physical [Editorial]
Redberg, R. F.
About This Journal [About This Journal]
In This Issue of Archives of Internal Medicine [In This Issue of Archives of Internal Medicine]
Patient-Centered Comparative Effectiveness Research: Essential for High-Quality Care [Commentary]
Slutsky, J. R., Clancy, C. M.
Food Surcharges and Subsidies: Putting Your Money Where Your Mouth Is [Editorial]
Katz, M. H., Bhatia, R.
Changing the Culture of Nursing Homes: The Physician's Role [Editorial]
Johnson, M.
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
How to break the vicious circle of antibiotic resistances?.
Page: 560DOI: 10.1097/MCI.0b013e32831dabd1Authors: Leone, Marc; Martin, Claude
Benefits of high-protein weight loss diets: enough evidence for practice?.
Page: 566DOI: 10.1097/MCI.0b013e32831daebdAuthors: Brehm, Bonnie J a; D'Alessio, David A b
Chronic pancreatitis.
Page: 572DOI: 10.1097/MCI.0b013e32831daddaAuthors: Conwell, Darwin L; Banks, Peter A
Sites:
Annals of Internal Medicine: Information relevant to internal medicine and related fields. [Registration required for full text.] Includes past issues.Archives of Internal Medicine: Archives of Internal Medicine is a bi-monthly professional medical journal published by the American Medical Association. Archives of Internal Medicine publishes original, peer-reviewed manuscripts on a full spectrum of internal medicine topics including cardiovascular disease, geriatrics, infec...
British Medical Journal: The aims of the electronic version of the BMJ are to publish rigorous accessible information that will help doctors improve their practice and will influence the international debate on health.
Cerrahpasa Journal of Medicine: (ISSN 1300-5227), the official journal of the Cerrahpasa Medical Faculty, is published quarterly in Turkish with abstracts in English.
Iranian Journal of Medical Sciences: A quarterly journal published by Shiraz University of Medical Sciences.
Journal of the American Medical Association: JAMA, the Journal of the American Medical Association, is a highly cited weekly medical journal that publishes peer-reviewed new medical research findings and editorial opinions on a wide variety of topics important to clinical practice and biomedical science. JAMA has the largest circulation of ...
MedBioWorld: Links to Internal Medicine, Gastroenterology & Pulmonology Journals
Medical Journal of Australia: Australia's leading peer reviewed journal of medical practice and clinical research.
Medicine: Bimonthly journal covering the latest results in clinical investigation relevant to hospital and office practice.
Rangel Medical Library: Links to informative sites arranged by internal medicine specialty.
Southern Medical Journal: Southern Medical Association's monthly publication devoted to continuing medical education.
The New England Journal of Medicine: The New England Journal of Medicine (NEJM) is a weekly general medical journal that publishes new medical research findings, review articles, and editorial opinion on a wide variety of topics of importance to biomedical science and clinical practice.
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