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16 October 2001 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 internal medicine physicians and medical students. The following 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.

Case Managers Improve Care of HIV Patients

A study of 2,437 HIV-infected adults found that patients with case managers who assist in co-ordinating their health care had fewer unmet needs and higher use of HIV medications (Article, p. 557). This is one of the first studies to show that case management services improve care for chronic, complex conditions. An editorial says that the federal funding freeze on the Ryan White Act, which partially funds case management services, will have "harmful consequences" on health care and will raise costs for both individuals and society (Editorial, p. 612).

Screening for Hereditary Colorectal Cancer Works and May Be Cost Effective

Between one and five percent of all cases of colorectal cancer are caused by a genetic condition, hereditary nonpolyposis colorectal cancer (HNPCC). Immediate relatives of colorectal cancer patients who also have HNPCC are at increased risk for colorectal and other cancers. Researchers found that established criteria identified colorectal cancer patients appropriate for genetic testing to identify HNPCC (Article, p. 566). In another article, researchers, using a computer simulation, found that screening colorectal cancer patients for HNPCC was cost effective, especially when the benefits to the patient's siblings and children were considered (Article, p. 577). Immediate relatives of colorectal cancer patients with HNPCC are advised to have earlier and more vigilant screening for colorectal cancer than average-risk individuals.

Quality Indicators for 22 Common Conditions Can Help Health Systems Evaluate and Greatly Improve Care for the Frail Elderly

(See news release on supplement to this issue of Annals.)

Herbal Medicines May Work, but Reliable Information is Lacking, and Herbs are not Standardized or Regulated Like Other Drugs. (Article, p. 594.)

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