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6 April 2004 Annals of Internal Medicine Tip Sheet

Annals of Internal Medicine is published by the American College of Physicians, an organization of more than 115,000 internal medicine physicians and medical students. These highlights are not intended to substitute for articles as sources of information. For an embargoed fax of an article, call 1-800-523-1546, ext. 2656, or 215-351-2656.

Diagnosis of Alzheimer Disease Associated with Reduced Life Expectancy

A new study of 521 people with newly diagnosed Alzheimer disease found that the median survival period was 4.2 years for men and 5.7 years for women (Article, p. 501), which is about half as long as people of similar age in the U.S. population would survive. The study found that the severity of cognitive impairment was strongly associated with decreased survival. Walking disturbances, falling, congestive heart failure and diabetes were also associated with decreased survival. An editorial writer says that the diagnosis of dementia and Alzheimer disease is a sentinel event, like a diagnosis of any ultimately fatal, chronic disease such as metastatic cancer. Realistic estimates of life expectancy can help patients, physicians and caregivers formulate plans for palliative and end-of-life care.

Task Force: Screen Adults for Alcohol Misuse in Primary Care Settings

The U.S. Preventive Services Task Force recommends screening and counseling for alcohol misuse in adults but not adolescents. The Task Force found good evidence that screening for misuse of alcohol, and behavioral counseling to reduce alcohol misuse, is effective in adults, including pregnant women (Clinical Guidelines, p. 554). The USPSTF did not evaluate the effectiveness of interventions to reduce alcohol dependence because the benefits of these interventions are well established.

Task Force Does Not Recommend ECG, Treadmill Tests or EBCT to Detect Presence of Severe Coronary Artery Stenosis or to Predict CHD

The U.S. Preventive Services Task Force recommends against routinely screening adults at low risk for CHD events to detect the presence of severe coronary artery stenosis or to predict coronary heart disease. This recommendation applies to screening with resting electrocardiography, exercise treadmill test, or electron-beam computerized tomography scanning for coronary calcium.

ACP Annual Session, April 22-24, 2004, New Orleans.

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