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4 January 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. NOTE: ACP and Annals of Internal Medicine will be closed from Monday, Dec. 27, 2004, until Monday, Jan. 3, 2005. Please call for articles and contact information for the January 4 issue of Annals before December 24. Thank you for your cooperation.

Review of Major Commercial Weight Loss Programs Finds Little Evidence and Great Variation in Components, Counseling Cost, and Effectiveness

(Review, p. 56.) (NOTE: This study is the subject of a video news release; call 215-351-2514 for satellite coordinates.)

Heavy Drinking is Associated with Risk for Stroke

A new analysis of data from a study of the nutrition habits and illnesses of 38,156 men found that heavy alcohol drinking was associated with increased risk for ischemic stroke (Article, p. 11). Light and moderate average alcohol use was generally not associated with an increased risk for stroke. Heavy drinking was defined as consuming more than two drinks daily; light or moderate drinking was defined as consuming two or less drinks a day. Moderate drinking of red wine was associated with lower risk for stroke, unlike other forms of alcohol. The study has limitations. Participants had relatively few strokes, strokes recorded were ischemic and not other forms of stroke; how alcohol affected the stroke rate was not studied; and the study could not clearly distinguish between different types of alcohol consumed by the participants.

Study: Patients Managed Own Blood Thinners and Had Few Complications

Many people take anticoagulants (blood thinners) and place themselves at risk for bleeding complications of treatment. In a randomized, controlled trial of patient self-management vs. clinic management of oral anticoagulants, patients who monitored the effect of their anticoagulant drug dose achieved similar levels of control over blood clotting as compared to patients who went to a clinic to have blood levels checked (Article, p. 1). Self-management patients also had fewer major complications (including death) and minor hemorrhages. The self-management patients measured the levels of anticoagulant medications with a portable device and adjusted the dose of the medication. An editorial writer says that patient self-management of anticoagulation is an idea whose time has come (Editorial, p. 73).

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