Table of Contents

November 5, 2002; 137 (9)

Articles

  • Next-Day Care for Emergency Department Users with Nonacute Conditions: A Randomized, Controlled Trial

    • Donna L. Washington,
    • Carl D. Stevens,
    • Paul G. Shekelle,
    • Philip L. Henneman,
    • and Robert H. Brook
    Ann Intern Med November 5, 2002 137:707-714

    Clinically detailed standardized screening criteria can safely identify patients at public hospital emergency departments for referral to next-day care. However, larger studies are needed to assess the possibility of adverse effects.

  • Cardioselective β-Blockers in Patients with Reactive Airway Disease: A Meta-Analysis

    • Shelley R. Salpeter,
    • Thomas M. Ormiston,
    • and Edwin E. Salpeter
    Ann Intern Med November 5, 2002 137:715-725

    Cardioselective β-blockers do not produce clinically significant adverse respiratory effects in patients with mild to moderate reactive airway disease. The results were similar for patients with concomitant chronic airway obstruction. Given their demonstrated benefit in such conditions as heart failure, cardiac arrhythmias, and hypertension, cardioselective β-blockers should not be withheld from patients with mild to moderate reactive airway disease.

  • Concomitant Leflunomide Therapy in Patients with Active Rheumatoid Arthritis despite Stable Doses of Methotrexate: A Randomized, Double-Blind, Placebo-Controlled Trial

    • Joel M. Kremer,
    • Mark C. Genovese,
    • Grant W. Cannon,
    • Jacques R. Caldwell,
    • John J. Cush,
    • Daniel E. Furst,
    • Michael E. Luggen,
    • Ed Keystone,
    • Michael H. Weisman,
    • William M. Bensen,
    • Jeffrey L. Kaine,
    • Eric M. Ruderman,
    • Patricia Coleman,
    • David L. Curtis,
    • Elliot J. Kopp,
    • Seth M. Kantor,
    • Jonathan Waltuck,
    • Herbert B. Lindsley,
    • Joseph A. Markenson,
    • Vibeke Strand,
    • Bruce Crawford,
    • Indra Fernando,
    • Karen Simpson,
    • and Joan M. Bathon
    Ann Intern Med November 5, 2002 137:726-733

    Combination therapy with leflunomide and methotrexate provides statistically significant clinical benefit in patients with active rheumatoid arthritis who are receiving methotrexate therapy. Leflunomide plus methotrexate is generally well tolerated and can be used safely with appropriate monitoring of liver enzyme and hematologic measures.

Brief Communications

  • Successful Discontinuation of Therapy for Disseminated Mycobacterium avium Complex Infection after Effective Antiretroviral Therapy

    • Stephen D. Shafran,
    • Laura D. Mashinter,
    • Peter Phillips,
    • Richard G. Lalonde,
    • M. John Gill,
    • Sharon L. Walmsley,
    • Emil Toma,
    • Brian Conway,
    • Ignatius W. Fong,
    • Anita R. Rachlis,
    • Kurt E. Williams,
    • Gary E. Garber,
    • Walter F. Schlech III,
    • and Fiona Smaill
    Ann Intern Med November 5, 2002 137:734-737

    Discontinuation of successful disseminated Mycobacterium avium complex therapy after a successful response to highly active antiretroviral therapy is safe and reduces patients' pill burdens, potential drug adverse effects, drug interactions, and costs of therapy.

Academia and Clinic

  • A Novel Incentive System for Faculty in an Academic Medical Center

    • Terry L. Brandt,
    • Clifford R. Romme,
    • Nicholas F. LaRusso,
    • and Keith D. Lindor
    Ann Intern Med November 5, 2002 137:738-743

    The authors describe a novel incentive system designed to promote high-quality care and increase patient access to health care while enhancing clinical and academic productivity and physician satisfaction. Key components of this system include annual targets, flexibility in meeting these targets, and ability to convert clinical productivity that exceeds what was necessary to meet the target to support scholarly activities.

Review

  • Diagnosis and Treatment of Acute Tubular Necrosis

    • Matthew L. Esson and
    • Robert W. Schrier
    Ann Intern Med November 5, 2002 137:744-752

    New information about the importance of early diagnosis and supportive care for patients with acute tubular necrosis has emerged. However, randomized trials of these interventions are needed to test their effect on the morbidity and mortality of this condition.

NIH Conferences

  • Dysautonomias: Clinical Disorders of the Autonomic Nervous System

    • David S. Goldstein,
    • David Robertson,
    • Murray Esler,
    • Stephen E. Straus,
    • and Graeme Eisenhofer
    Ann Intern Med November 5, 2002 137:753-763

    The term dysautonomia refers to a change in autonomic nervous system function that adversely affects health. The authors discuss chronic autonomic failure; autonomic function in chronic orthostatic intolerance, essential hypertension, panic disorder, and congestive heart failure; and dysautonomia and the chronic fatigue syndrome and neurocardiology.

Editorials

  • Deferred Care for Patients in the Emergency Department

    • Eric B. Larson
    Ann Intern Med November 5, 2002 137:764-765

    In this issue, Washington and colleagues describe a system designed to identify persons in an emergency department who have symptoms related to abdominal and pelvic pain, musculoskeletal pain, or respiratory infection and meet criteria for deferred care. The deferred care approach is one solution to the complex problem of emergency department overcrowding that faces many busy urban centers. A better overall solution would be widespread availability of timely and effective ambulatory care, based on continuous physician–patient relationships.

  • Fresh Air and β-Blockade

    • Paul E. Epstein
    Ann Intern Med November 5, 2002 137:766-767

    Salpeter and colleagues' elegant meta-analysis in this issue has helped put to rest a question that is both clinically important and controversial: Can cardioselective β-blockers be used safely in patients with recognized obstructive lung disease?

On Being a Doctor

  • Smell

    • Brett DiGiovanna
    Ann Intern Med November 5, 2002 137:768-769

    Mr. Rosen looked at me and asked if I still took anatomy, telling me that medical students were spoiled. I asked him why. “The formaldehyde,” he replied, “you never had to smell a rotting body on a battlefield.“

  • Bryant

    • Richard B. Weinberg
    Ann Intern Med November 5, 2002 137:770-771

    The most peculiar thing about being fired is that everybody stops talking to you. “It's time for a change,” they told me, and with that, my decade of service as a section head was over.

Letters

  • Inaccurate Glucose Determination by Fingerstick in a Patient with Peripheral Arterial Disease

    • Tawee Tanvetyanon,
    • Michael D. Walkenstein,
    • and Antonio Marra
    Ann Intern Med November 5, 2002 137:W1

  • Subgroup Results in the DASH-Sodium Trial

    • Gesche Jürgens and
    • Niels Graudal
    Ann Intern Med November 5, 2002 137:772

  • Subgroup Results in the DASH-Sodium Trial

    • William M. Vollmer,
    • Frank M. Sacks,
    • and Lawrence J. Appel
    Ann Intern Med November 5, 2002 137:772-773

  • Public Expectation for Annual Physical Examinations

    • Marvin S. Wool
    Ann Intern Med November 5, 2002 137:773

  • Public Expectation for Annual Physical Examinations

    • Caroline Poplin
    Ann Intern Med November 5, 2002 137:773

  • Public Expectation for Annual Physical Examinations

    • Kei Mukohara
    Ann Intern Med November 5, 2002 137:773-774

  • Public Expectation for Annual Physical Examinations

    • Sylvia K. Oboler,
    • Allan V. Prochazka,
    • and Robert J. Anderson
    Ann Intern Med November 5, 2002 137:774

  • Diphtheria and Tetanus Immunity

    • Dominic J. Balestra
    Ann Intern Med November 5, 2002 137:774-775

  • Diphtheria and Tetanus Immunity

    • Geraldine M. McQuillan and
    • Susan Y. Chu
    Ann Intern Med November 5, 2002 137:775

  • Lyme Disease Controversy: Use and Misuse of Language

    • Andrew Lautin
    Ann Intern Med November 5, 2002 137:775

  • Lyme Disease Controversy: Use and Misuse of Language

    • Edward L. McNeil
    Ann Intern Med November 5, 2002 137:775-776

  • Lyme Disease Controversy: Use and Misuse of Language

    • Kenneth B. Liegner
    Ann Intern Med November 5, 2002 137:776

  • Lyme Disease Controversy: Use and Misuse of Language

    • Raphael B. Stricker
    Ann Intern Med November 5, 2002 137:776

  • Lyme Disease Controversy: Use and Misuse of Language

    • Leonard H. Sigal
    Ann Intern Med November 5, 2002 137:776-777

  • Octreotide Therapy for the Sjögren Syndrome

    • Tri G. Phan,
    • Tom P. Gordon,
    • Martin H.N. Tattersall,
    • and Robert H. Loblay
    Ann Intern Med November 5, 2002 137:777-778

  • Correction: Guidelines for Using Antiretroviral Agents among HIV-Infected Adults and Adolescents

    Ann Intern Med November 5, 2002 137:778

Medical Writings

  • Writing for Our Lives: Physician Narratives and Medical Practice

    • Kate Scannell
    Ann Intern Med November 5, 2002 137:779-781

    My entrenched skepticism about the ability of a single view to function as collective truth has fostered in me a driving curiosity about other peoples' experiences and a ready desire to hear them—elements that have enlivened my life as a physician and writer.

Medical Writings: Book Notes

  • Travel & Routine Immunizations: A Practical Guide for the Medical Office

    • James Nora and
    • Bradley N. Doebbeling
    Ann Intern Med November 5, 2002 137:782

  • Vasculitis

    • Evelyn V. Hess
    Ann Intern Med November 5, 2002 137:782

Ad Libitum

Book Listings

Medical Notices

Summaries for Patients

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This Issue

November 5, 2002; 137 (9)
  1. Articles
  2. Brief Communications
  3. Academia and Clinic
  4. Review
  5. NIH Conferences
  6. Editorials
  7. On Being a Doctor
  8. Letters
  9. Medical Writings
  10. Medical Writings: Book Notes
  11. Ad Libitum
  12. Book Listings
  13. Medical Notices
  14. Summaries for Patients

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