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2 February 1999 Annals of Internal Medicine Tip Sheet

Annals of Internal Medicine is published by the American College of Physicians-American Society of Internal Medicine (ACP-ASIM), an organization of more than 115,000 physicians trained in internal medicine.

Laramie Physician Comments on Shepard Slaying (On Being a Doctor, p. 235.)

Studies Find Ethnic Groups Get Heart Treatment Comparable to Whites, … If They Have Health Insurance and Are Treated in Hospitals that Perform the Procedures

Many studies have shown that the death rate from heart disease is higher for black Americans than white, and that black Americans receive fewer cardiovascular procedures. Two studies in today's Annals of Internal Medicine found variables in the health care system that may affect these results.

A longitudinal study of black and white patients in the U.S. Renal Data System found that the initial threefold difference in use of three common heart procedures was almost eliminated once patients received Medicare insurance and entered a comprehensive system of medical care (Article, p. 173).

Another study of coronary surgery and angioplasty found no variations in use of the procedures by sex, ethnic group or health insurance status in hospitals that offered the procedures but significantly less use among patients seen in hospitals that did not perform the procedures (Article, p. 183).

An editorial says the articles show that "access, quality and equity are related." (Editorial, p. 231.)

Two Studies: U.S. Must Provide Better Surveillance for Foodborne Illnesses

A study of a 1997 outbreak of cyclosporiasis was associated with fresh Guatemalan raspberries despite prevention and control measures after a similar outbreak in 1996 (Article, p. 210). "Faster traceback of product to a specific location and timely regulatory action" may limit future outbreaks, says an editorial, but the best way to prevent such outbreaks is to require irradiation of imported raspberries, an effort that will require leadership from federal food safety agencies (Editorial, p. 233).

A study of Escherichia coli infection from drinking unprocessed apple juice in 1996 was traced to apples probably contaminated on the ground by sheep, deer or cow waste (Article, p. 202).

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