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20 March 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.

ACP-ASIM Issues Four New Guidelines

Antibiotics Not Needed For Most Respiratory Infections

Heart Disease Risk Factors Important for Young as Well as Older Men

Cholesterol level, blood pressure, and cigarette smoking, factors known to increase older menŐs risk for heart disease, also predict risk for heart disease in men aged 18 to 39, a new study finds (Article, p. 433). After initial screening between 1967 and 1973, researchers studied 11,016 men for 20 years. The study indicates that early screening of young men for heart disease risk factors may be useful, the authors say, since many of the risk factors can be reduced by lifestyle changes or drug therapy.

HIV Genotype Testing is Cost-Effective, New Study Finds

Tests of HIV virus genes for signs of resistance to particular drugs can help identify drug-resistant mutations. This information could be used to guide the choice of drug therapy, especially after a given therapy fails. A new cost-effectiveness study analyzed the tests, which cost approximately $400 each, in terms of quality-adjusted life-year gained (Article, p. 440). The study found the genotypic resistance tests would be cost-effective in patients whose anti-HIV drug therapy had failed and possibly cost-effective before beginning the first anti-HIV drug regimen if physicians suspect that at least 4 to 5 percent of the virus in a community is drug resistant. An editorial says that the study shows resistance testing is warranted in clinical practice (Editorial, p. 475).

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