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15 January 2008 Annals of Internal Medicine Tip Sheet

Annals of Internal Medicine is published by the American College of Physicians on the first and third Tuesday of every month. 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. Past highlights are accessible as well.

1. Internal Medicine Organization Issues New Guidelines to Improve Palliative Care of Three Symptoms at End of Life

--Most Common EOL Symptoms are Pain, Difficult Breathing, and Depression

(NOTE: Separate news release is issued. Other items on palliative care in this issue include an Update (p. 135) that reviews literature to answer seven common questions, such as, Does opioid use hasten death in patients with advanced disease" and Can earlier palliative care in the ICU reduce length of stay for patients at high risk for death" A systematic review looks at "Evidence of Improving Palliative Care at the End of Life" (p. 147).

2. Sickle Cell Disease Causes Much More Pain Than Formerly Thought

(NOTE: Separate news release is issued. This article is subject of video news release.)

3. Antibiotic-Resistant Staphylococcal Infections Discovered in Men Who Have Sex With Men

A multi-drug resistant strain of the S. aureus bacteria isolated in two cities was more common in areas where male same-sex couples lived and appeared to be more commonly transmitted sexually among men who have sex with men than those who do not, a new population-based, retrospective study found.
(NOTE: This paper is being released early online at the Web site of Annals of Internal Medicine It will appear in the Feb. 19, 2008, print edition of the journal.)

4. Releasing Health Care Performance Data May Not Improve Care

Peer-reviewed evidence on public reporting as a mechanism to improve quality of health care found that public reporting stimulates hospital quality improvement activity but doesn't consistently influence consumers when they choose a health plan (Improving Patient Care, p. 111).
Few studies looked at improving patient safety and patient-centeredness or at the new public reporting systems.
An accompanying editorial writer says that the content and format of the public reports on quality of care have been difficult to understand and use and should be improved before re-evaluating the effect of public reporting on quality (Editorial, p. 160).

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