Table of Contents

May 16, 2000; 132 (10)

Articles

  • Cost-Effectiveness of Cholesterol-Lowering Therapies according to Selected Patient Characteristics

    • Lisa A. Prosser,
    • Aaron A. Stinnett,
    • Paula A. Goldman,
    • Lawrence W. Williams,
    • Maria G.M. Hunink,
    • Lee Goldman,
    • and Milton C. Weinstein
    Ann Intern Med May 16, 2000 132:769-779

    Cost-effectiveness of cholesterol-lowering treatments was found to vary significantly when adjusted for sex, age, and the presence or absence of additional risk factors. Primary prevention with a step I diet seems to be cost-effective for most risk subgroups but not for otherwise healthy young women. Primary prevention with a statin may not be cost-effective for younger men and women with few risk factors, given the option of secondary prevention and of primary prevention in older age ranges.

  • Cost-Effectiveness of 3-Hydroxy-3-Methylglutaryl Coenzyme A Reductase Inhibitor Therapy in Older Patients with Myocardial Infarction

    • David A. Ganz,
    • Karen M. Kuntz,
    • Gretchen A. Jacobson,
    • and Jerry Avorn
    Ann Intern Med May 16, 2000 132:780-787

    The cost-effectiveness ratios of statin therapy in older patients who have previously had myocardial infarction are reasonable under a variety of assumptions about drug efficacy, drug cost, and rates of cardiac and cerebrovascular events. Pending results of randomized, controlled trials of secondary prevention in patients in this age group, statin therapy seems to be as cost-effective as many routinely accepted medical interventions in this setting.

  • Oral Clonidine in Postmenopausal Patients with Breast Cancer Experiencing Tamoxifen-Induced Hot Flashes: A University of Rochester Cancer Center Community Clinical Oncology Program Study

    • Kishan J. Pandya,
    • Richard F. Raubertas,
    • Patrick J. Flynn,
    • Harry E. Hynes,
    • Richard J. Rosenbluth,
    • Jeffrey J. Kirshner,
    • H. Irving Pierce,
    • Vladimir Dragalin,
    • and Gary R. Morrow
    Ann Intern Med May 16, 2000 132:788-793

    Oral clonidine at a dosage of 1 mg/d is effective against tamoxifen-induced hot flashes in postmenopausal women with breast cancer.

Brief Communications

  • Antibody Inhibitors to von Willebrand Factor Metalloproteinase and Increased Binding of von Willebrand Factor to Platelets in Ticlopidine-Associated Thrombotic Thrombocytopenic Purpura

    • Han-Mou Tsai,
    • Lawrence Rice,
    • Ravindra Sarode,
    • Thomas W. Chow,
    • and Joel L. Moake
    Ann Intern Med May 16, 2000 132:794-799

    In patients who developed ticlopidine-associated thrombotic thrombocytopenic purpura (TTP), autoantibodies to von Willebrand factor metalloproteinase were formed; this led to the same type of von Willebrand factor abnormalities seen in patients with idiopathic acute TTP. The findings suggest that failure to process large and unusually large von Willebrand factor multimers in vivo caused binding of von Willebrand factor to platelets, systemic platelet thrombosis, and TTP.

  • Absorption and Hemodynamic Effects of Airway Administration of Adrenaline in Patients with Severe Cardiac Disease

    • Konstantinos Raymondos,
    • Bernhard Panning,
    • Martin Leuwer,
    • Guido Brechelt,
    • Thomas Korte,
    • Michael Niehaus,
    • Jürgen Tebbenjohanns,
    • and Siegfried Piepenbrock
    Ann Intern Med May 16, 2000 132:800-803

    This prospective study demonstrates that administration of adrenaline into the airways is hemodynamically effective and increases adrenaline plasma levels in adults with severe cardiac disease.

Academia and Clinic

  • The First Positive: Computing Positive Predictive Value at the Extremes

    • James E. Smith,
    • Robert L. Winkler,
    • and Dennis G. Fryback
    Ann Intern Med May 16, 2000 132:804-809

    Computing the positive predictive value (PPV) is difficult in the case of a new test for a rare disorder. The authors present some tools for thinking about PPV calculations for such scenarios.

Review

  • Accuracy of the Papanicolaou Test in Screening for and Follow-up of Cervical Cytologic Abnormalities: A Systematic Review

    • Kavita Nanda,
    • Douglas C. McCrory,
    • Evan R. Myers,
    • Lori A. Bastian,
    • Vic Hasselblad,
    • Jason D. Hickey,
    • and David B. Matchar
    Ann Intern Med May 16, 2000 132:810-819

    Available high-quality data are insufficient to allow estimation of test operating characteristics of new cytologic methods for cervical screening. Future studies of these technologies should apply adequate reference standards. Most studies of the conventional Papanicolaou test are severely biased: The best estimates suggest that the test is only moderately accurate and does not achieve concurrently high sensitivity and specificity.

Perspectives

  • In Search of a Good Death: Observations of Patients, Families, and Providers

    • Karen E. Steinhauser,
    • Elizabeth C. Clipp,
    • Maya McNeilly,
    • Nicholas A. Christakis,
    • Lauren M. McIntyre,
    • and James A. Tulsky
    Ann Intern Med May 16, 2000 132:825-832

    This study describes the attributes of a good death, as understood by various participants in end-of-life care.

Medicine and Public Issues

  • The Balanced Budget Act of 1997: Its Impact on U.S. Teaching Hospitals

    • Robert Dickler and
    • Gina Shaw
    Ann Intern Med May 16, 2000 132:820-824

    The authors examine the overall financial and organizational effect of the Balanced Budget Act of 1997 on teaching hospitals in the United States and consider its effect on residency education.

Editorial

  • Using Cost-Effectiveness Analysis To Target Cholesterol Reduction

    • Alan M. Garber
    Ann Intern Med May 16, 2000 132:833-835

    The studies by Ganz and Prosser and their colleagues in this issue evaluate statin therapy in clinically important populations that were not studied adequately in randomized trials. These studies reinforce the message that lipid management for secondary prevention should be a high priority, regardless of whether the patient is female or male, young or old.

On Being a Doctor

  • Shattered All

    • Bruce Leff
    Ann Intern Med May 16, 2000 132:837-838

    How had such a ripe opportunity for a “good” death been botched so badly, and why had so many people experienced such suffering?

  • A Doctor in the Family

    • Bhuvana Chandra
    Ann Intern Med May 16, 2000 132:838-839

Letters

  • Antithrombotic Therapy To Prevent Stroke in Patients with Atrial Fibrillation

    • Daniel E. Singer
    Ann Intern Med May 16, 2000 132:841

  • Antithrombotic Therapy To Prevent Stroke in Patients with Atrial Fibrillation

    • Robert G. Hart and
    • Lesly A. Pearce
    Ann Intern Med May 16, 2000 132:841-842

  • Chronic Infection and Coronary Risk

    • Michael Mogadam
    Ann Intern Med May 16, 2000 132:842

  • Elevated Ambulatory and Normal Office Blood Pressure

    • Arthur G. Goldman
    Ann Intern Med May 16, 2000 132:842

  • Elevated Ambulatory and Normal Office Blood Pressure

    • Thomas G. Pickering,
    • Jennifer E. Liu,
    • and Mary J. Roman
    Ann Intern Med May 16, 2000 132:842

  • The Sharer

    • Morton Glanz
    Ann Intern Med May 16, 2000 132:842-843

  • Diagnosis of Intercritical Gout

    • James R. Johnson
    Ann Intern Med May 16, 2000 132:843

  • Diagnosis of Intercritical Gout

    • Eliseo Pascual,
    • Enrique Batlle-Gualda,
    • and Agustín Martínez
    Ann Intern Med May 16, 2000 132:843

  • Transmission of Tuberculosis in a Jail

    • William W. Stead
    Ann Intern Med May 16, 2000 132:843

  • Prophylactic Fluconazole in Liver Transplant Recipients

    • Nina Singh and
    • Victor L. Yu
    Ann Intern Med May 16, 2000 132:843-844

  • Role of Communication Skills Training

    • C. Andrew Brodkin and
    • Kayla I. Brodkin
    Ann Intern Med May 16, 2000 132:844

  • Update in Preventive Medicine

    • Joel H. Merenstein
    Ann Intern Med May 16, 2000 132:844-845

  • Gated Myocardial Perfusion Scan Leading to Diagnosis of Unsuspected Massive Pulmonary Embolism

    • Gabriel Soudry and
    • Pablo E. Dibos
    Ann Intern Med May 16, 2000 132:845

  • Infection with Hepatitis C Virus Genotype 4 Is Associated with a Poor Response to Interferon-α

    • Hervé Zylberberg,
    • M. L. Chaix,
    • and Christian Bréchot
    Ann Intern Med May 16, 2000 132:845-846

  • A Common Problem with Therapy for HIV Infection

    • Marcial Delgado Fernández,
    • José Luis Zambrana García,
    • and Felipe Díez García
    Ann Intern Med May 16, 2000 132:846

  • Most Gastric Low-Grade B-Cell Lymphomas of Mucosa-Associated Lymphoid Tissue Persist after Helicobacter pylori Eradication

    • Graziella Pinotti,
    • Claudio Chini,
    • and Carlo Capella
    Ann Intern Med May 16, 2000 132:846

  • Immediate Cerebral Angiography and Mechanical Fragmentation of Cerebral Embolus after Percutaneous Myocardial Revascularization

    • Eelco F.M. Wijdicks,
    • Kent R. Thielen,
    • and Guy S. Reeder
    Ann Intern Med May 16, 2000 132:846-847

  • Rapid Bioprosthetic Valve Degeneration in a Patient Undergoing Hemodialysis

    • Harvey S. Hahn and
    • Seymour S. Maze
    Ann Intern Med May 16, 2000 132:847

Medical Writings: Book Notes

  • Hypertension: A Companion to Brenner and Rector's The Kidney

    • Gerald Schulman
    Ann Intern Med May 16, 2000 132:848

  • Survey Methods in Community Medicine

    • Christopher Maylahn
    Ann Intern Med May 16, 2000 132:848

Currents

  • From the Ground Up: A Look at the Role of Foundations in Health

    • Linda Gundersen
    Ann Intern Med May 16, 2000 132:849

Ad Libitum

Book Listings

Medical Notices

  • Medical Notices

    Ann Intern Med May 16, 2000 132:0

Summaries for Patients

  • The Cost Effectiveness of Lowering Cholesterol in Individual Patients

    Ann Intern Med May 16, 2000 132:769

  • Cost-Effectiveness of Lowering Cholesterol in Older Patients after Heart Attack

    Ann Intern Med May 16, 2000 132:780

  • Using the Medicine Clonidine To Treat Hot Flashes in Breast Cancer Patients Taking Tamoxifen

    Ann Intern Med May 16, 2000 132:788

  • Mechanisms of Thrombotic Thrombocytopenic Purpura (TTP), a Complication Associated with the Drug Ticlopidine

    Ann Intern Med May 16, 2000 132:794

  • The Effect on Blood Pressure of Putting Large Doses of Adrenaline into the Airways

    Ann Intern Med May 16, 2000 132:800
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This Issue

May 16, 2000; 132 (10)
  1. Articles
  2. Brief Communications
  3. Academia and Clinic
  4. Review
  5. Perspectives
  6. Medicine and Public Issues
  7. Editorial
  8. On Being a Doctor
  9. Letters
  10. Medical Writings: Book Notes
  11. Currents
  12. Ad Libitum
  13. Book Listings
  14. Medical Notices
  15. Summaries for Patients

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