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1 November 2005 Annals of Internal Medicine Tip Sheet

Annals of Internal Medicine is published by the American College of Physicians. These highlights are not intended to substitute for articles as sources of information. For an embargoed copy of an article, call 1-800-523-1546, ext. 2656, or 215-351-2656. Leave fax or e-mail and article topics.

Adult Survivors of Childhood Cancer Often Have Performance Limitations

A study of 11,481 childhood cancer survivors found that 20 percent had a physical performance limitation compared with 12 percent of their siblings who did not have cancer (Article, p. 639). Six times as many survivors, compared with siblings, were unable to attend school or work. Survivors of brain and bone cancer were the most severely affected among all types of cancer surveyed. Authors point out limitations of their study, including the fact that cancer treatment techniques have improved over the past 20 years. But they say adult survivors of childhood cancer “should be monitored for functional loss throughout their lives and referred for appropriate rehabilitation services when indicated.”

Rehabilitation Programs Improve Survival Rates After Heart Attacks --Exercise Component May Help but Is Not Essential

An analysis of published studies (a meta-analysis) of the effect of cardiac rehabilitation programs after heart attacks found that people who participated in such programs lived longer and had better quality of life than those who did not participate in programs (Article, p. 659). The programs, called secondary prevention programs because they take place after an illness to prevent recurrence or progression of the disease, included education and counseling about coronary risk factors, education plus supervised exercise programs, and structured exercise programs alone. Researchers found benefits associated with all three types of programs. Overall, they positively affected risk factor profiles, such as blood pressure and cholesterol, improved functional status or quality of life for participants, and reduced subsequent heart attacks by 17 percent over a follow-up period of one year.

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