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2 March 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.

Treatment of Suspected TB Often Delayed; Therapy Must Be Initiated Immediately

A nine-year study of hospitalized patients in a large health system found that only 25 percent of people with suspected tuberculosis received the appropriate immediate treatment (Article, p. 404). Authors say that delaying treatment for even a day or two could allow the highly contagious disease to infect others.

A randomized, placebo-controlled trial comparing four bedtime insulin regimens in patients with poorly controlled type 2 diabetes found the combination of bedtime insulin, in self-adjusted doses, and the oral drug metformin most successful. The combination prevented weight gain during therapy and resulted in best overall control of blood sugar levels and fewest hypoglycemic episodes (Article, p. 389). An editorial says the study shows that blood sugar levels of people with type 2 diabetes can be controlled and such control will probably lessen many of the damaging long-term complications of this common, chronic, severe disease (Editorial, p. 440).

A large study of elderly people with chronic lung disease found that those who received flu vaccinations had significantly fewer outpatient visits, hospitalizations and deaths due to complications of influenza (Article, p. 397). Authors urge health care providers to vaccinate the more than 3 million older adults who have chronic lung disease and are at especially high risk for complications of influenza.