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19 February 2002 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.

Second Colorectal Cancers Often Develop Despite Follow-Up Tests

The incidence of second primary colorectal cancer is high despite intensive regular surveillance colonoscopy after treatment of the initial cancer, a new analysis of data from three studies found (Article, p. 261). The incidence of second colorectal cancer was higher among patients with a history of colon cancer than the incidence of first colorectal cancer in the general population. Many second cancers were diagnosed within one year after a normal colonoscopy, indicating the need for further research to determine the best schedule for surveying the colon after discovery and treatment of colorectal cancer.

Blood Supply Safety Varies Between Developed and Developing Countries

An article reviewing the current status of blood safety in several countries finds that in developed countries, viral transmission from contaminated blood or blood products is extremely rare, but, in developing countries, up to 10 percent of HIV infections result from transfusion of blood or blood products (Medicine and Public Issues, p. 312). Developed countries have adopted improved diagnostic tests and screening procedures, established policies for inactivating HIV in blood products, set up reimbursement programs for people with transfusion-acquired viral infections, and held criminal investigations of government and blood industry leaders accused of delaying implementation of potential blood safety measures. In developing countries, an estimated 45 percent of blood donations are not screened for HIV and hepatitis C or B viruses. According to the authors, implementing policies to protect the blood supply may shrink available resources in developing countries and take away from other gains in health.

Review: Identifying and Treating the Suicidal Patient

A review of data on the assessment and management of suicidal patients identifies personal and family traits, availability of means for committing suicide, and other factors linked to suicides and attempted suicides (Review, p. 302).

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