 |
 |
|
|
Articles 
Kay-Tee Khaw, Nicholas Wareham, Sheila Bingham, Robert Luben, Ailsa Welch, and Nicholas Day In this study of patients recruited from general practice, the risk for cardiovascular disease and total mortality rose continuously throughout the range of hemoglobin A1c concentrations seen in the general population. Seventy-five percent of the excess population mortality risk associated with a hemoglobin A1c concentration greater than 5.0% occurred in persons with concentrations between 5.0% and 6.9%.
Elizabeth Selvin, Spyridon Marinopoulos, Gail Berkenblit, Tejal Rami, Frederick L. Brancati, Neil R. Powe, and Sherita Hill Golden This meta-analysis of observational studies in patients with diabetes shows that increased serum hemoglobin A1c levels are associated with an increased risk for cardiovascular disease in both type 1 and type 2 diabetes.
Gert J.D. Bergman, Jan C. Winters, Klaas H. Groenier, Jan J.M. Pool, Betty Meyboom-de Jong, Klaas Postema, and Geert J.M.G. van der Heijden This trial compared manipulative therapy plus usual care for shoulder dysfunction and pain with usual care alone. Manipulative therapy appears to be an effective treatment option for patients with shoulder pain that is not due to trauma, fracture, rupture, or dislocation.
Andrés Esteban, Pilar Fernández-Segoviano, Fernando Frutos-Vivar, José Antonio Aramburu, Laura Nájera, Niall D. Ferguson, Inmaculada Alía, Federico Gordo, and Fernando Ríos As measured in a series of autopsied patients with suspected acute respiratory distress syndrome, the American–European Consensus Conference definition did not detect 25% of patients with this syndrome (sensitivity, 75%). Among patients who did not have this syndrome at autopsy, 16% satisfied the diagnostic criteria (specificity, 84%).
Improving Patient Care
Jason M. Lappé, Joseph B. Muhlestein, Donald L. Lappé, Rodney S. Badger, Tami L. Bair, Ruth Brockman, Thomas K. French, Linda C. Hofmann, Benjamin D. Horne, Susan Kralick-Goldberg, Nan Nicponski, Janette A. Orton, Robert R. Pearson, Dale G. Renlund, Holly Rimmasch, Colleen Roberts, and Jeffrey L. Anderson The authors introduced a program to increase prescribing of appropriate discharge medications to patients with cardiovascular disease in an integrated multihospital system. In this nonrandomized before–after study, the program was associated with a 19% reduction in cardiovascular mortality 1 year after discharge.
Updates
Steven H. Stein This year's Update in Oncology incorporates articles on breast cancer, lung cancer, the immune response, prostate cancer, multiple myeloma, and colon cancer.
Reviews
Claude A. Piantadosi and David A. Schwartz This review describes the clinical, etiologic, and physiologic basis of the acute respiratory distress syndrome and summarizes how its molecular pathogenesis leads to respiratory failure. The authors describe a physiologic basis for the respiratory management of patients with this syndrome.
Perspectives
Wendy Levinson and Nicole Lurie The profession of medicine is becoming feminized as the number of women entering medicine has increased over the past several decades. The authors predict notable changes in 4 domains: the patient–physician relationship, the local delivery of care, the societal delivery of care, and the medical profession itself.
Editorials
Hertzel C. Gerstein What can we conclude from the reports by Khaw and Selvin and colleagues in this issue? First, the glycosylated hemoglobin level is an independent progressive risk factor for cardiovascular events, regardless of diabetes status. Second, glycosylated hemoglobin belongs on the list of cardiovascular risk factors. Third, these studies highlight the importance of ongoing clinical trials of reducing glycosylated hemoglobin levels to reduce cardiovascular risk.
Catherine De Angelis, Jeffrey M. Drazen, Frank A. Frizelle, Charlotte Haug, John Hoey, Richard Horton, Sheldon Kotzin, Christine Laine, Ana Marusic, A. John P.M. Overbeke, Torben V. Schroeder, Harold C. Sox, and Martin B. Van Der Weyden In this editorial, published simultaneously in all member journals, the International Committee of Medical Journal Editors (ICMJE) proposes comprehensive trials registration as a solution to the problem of selective awareness of clinical trials. The Committee announces that all 11 ICMJE member journals will adopt a trials-registration policy that promotes this goal.
On Being a Doctor
Lawrence Zaroff For doctors practicing for 20 to 30 years, the chance of avoiding a malpractice suit is equivalent to a tadpole growing wings and becoming a monarch. For 29 years, I kept up with my changing specialty, asked for appropriate consultations, and was available when called, but a foreign body of the heart turned me into your average frog.
Letters "Wait-and-See": An Alternative Approach to Managing Acute Hepatitis C with High-Dose Interferon- Neville R. Pimstone, Daniel Pimstone, Theparat Saicheur, Jerry Powell, and Andy S. Yu Future Research on Disclosure of Medical Errors
D-Dimer and Venous Thromboembolism
Factor V Leiden and Venous Thromboembolism
Excess Body Weight in Critically Ill Patients
Update in Perioperative Medicine
Occupational Exposure to Bloodborne Pathogens
Sarah Garrison
Jason Karlawish
Jennifer Fisher Wilson
| |||||||||||||||||||||||||||||||||||||||||||||||||
In this Issue
Articles
Previous Issue
Monotherapy
