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During 12-week treatment of osteoarthritis, patients taking rofecoxib were less likely to discontinue using medication because of gastrointestinal side effects than patients taking naproxen. The 2 drugs were equally effective in treating osteoarthritis.
Magnetic resonance cholangiopancreatography is a noninvasive imaging test with excellent overall sensitivity and specificity for showing biliary obstruction and its location. Although the test is less sensitive for detecting stones or malignant obstruction, the differences are small and may not be clinically important.
Many general pulmonary outpatients and patients facing lung surgery believe that a thoracotomy promotes metastasis from lung cancer. This belief is particularly prevalent among African-American patients, and it may help to explain racial differences in rates of surgery for early-stage lung cancer.
Early in the SARS epidemic, patients who had not been suspected of having SARS transmitted the coronavirus to many health care workers in a Hong Kong hospital. The outbreak of SARS in health care workers led the hospital to isolate suspected SARS cases and require health care workers to use protective devices.
This article defines patient-centered access, identifies its primary characteristics, discusses its key principles, and considers its future evolution.
The authors recommend selective use of plain radiographs to evaluate knee pain. The Ottawa knee rules reliably identify patients who do not have knee fracture. A careful physical examination should suffice to decide when to refer patients with potential meniscal and ligament injuries, and clinical criteria rather than plain films are best for evaluating possible osteoarthritis.
Severe acute respiratory syndrome (SARS) has caused a small number of deaths compared with other public health scourges, yet the SARS epidemic has much to teach us. The author describes 4 enduring lessons.
The coronavirus that causes SARS is the latest in a series of emerging pathogens that challenge our global society. The virus has a remarkable ability to amplify its communicability to become an almost “perfect” nosocomial pathogen. We must institutionalize the critical lessons learned from managing the 2003 SARS epidemic as we prepare for the next emerging pathogen.
The articles in the supplement to this issue show that internal medicine is committed to first-class training in geriatric medicine. So is family medicine. This undertaking is important and difficult, and the 2 disciplines should join forces wherever possible.
The progressive aging of the U.S. population presents an unprecedented demographic challenge to our health care system. To address this imperative, gerontology and geriatrics must become embedded into medical education at all levels. This editorial focuses on partnerships between general internal medicine and the field of geriatrics.
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