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4 October 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.

More Heart Patients Die in the Hospital in December Than Other Months --But Study Shows Hospital Care Similar to Other Months

A study of 127,959 Medicare patients hospitalized between January 1994 and 1996 with heart attacks found that 30-day death rates were higher in December than in other months, but delivery of proven therapies was similar in both time periods (Article, p. 481). Approximately 22 percent of patients hospitalized in December died within 30 days compared with 20.1 percent of patients hospitalized in other months. The study authors looked for use of aspirin, beta-blockers, clot-dissolving drugs and procedures such as balloon angioplasty. They say they do not know why the death rate is higher in December.

Study: Majority of Americans Likely to Become Overweight or Obese, with Serious Implications for Future Health Care and Costs

An analysis of data on 4,117 normal-weight white men and women found that within four years, between one tenth and one quarter became overweight and a similar proportion of overweight people became obese (Article, p. 473). In the long term (between 10 and 30 years), more than half of the women and men became overweight, and about one third of the women and one quarter of the men became obese. The researchers say these figures are greater than most other estimates and suggest that the future burden of obesity-associated chronic diseases such as cardiovascular disease, several forms of cancer, diabetes and knee arthritis, will be substantial.

ACP Does Not Recommend for or Against Screening for Hereditary Hemochromatosis

The American College of Physicians examined published studies on hereditary hemochromatosis, a genetic disease in which the body absorbs too much iron from food. ACP suggests that the current evidence does not clearly identify the risks and benefits of screening for hereditary hemochromatosis (Clinical Guidelines, p. 517). However, when trying to establish a diagnosis, physicians should perform blood tests to measure serum ferritin and transferrin saturation tests. Hemochromatosis can increase iron deposits in body organs, which can cause serious liver damage such as cirrhosis and liver cancer, diabetes, heart failure, arthritis, and skin discoloration. Patients who have relatives with hemochromatosis should tell their personal physicians.

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