We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
In This Issue of Archives of Internal Medicine |

In This Issue of Archives of Internal Medicine FREE

Arch Intern Med. 2011;171(13):1145. doi:10.1001/archinternmed.2011.293.
Text Size: A A A
Published online

In a longitudinal study to investigate how diet may be influenced by food resources located within varying distances from homes, Boone-Heinonen et al estimated how neighborhood fast food, supermarket, and grocery store availability affect diet behaviors in a cohort of more than 5000 young adults in the Coronary Artery Risk Development in Young Adults (CARDIA) study. In addition, the authors tested if lower-income individuals may be more sensitive to resources in close proximity to their homes. These findings provide some support for zoning restrictions on fast food restaurants within 3 km of low-income residents but suggest that increased access to food stores may require complementary or alternative strategies to promote dietary behavior change.

See Article

While several epidemiologic studies suggested that higher sodium and lower potassium intakes were associated with increased risk of cardiovascular diseases (CVDs), few studies have examined joint effects of dietary sodium and potassium intake on risk of mortality. In a prospective cohort study of a nationally representative sample of US adults, Yang et al examined the association between the estimated usual intake of sodium and potassium and sodium-potassium ratio and risk of all-cause and CVD mortality. We found that higher sodium intake was associated with increased all-cause mortality, but higher potassium intake was associated with lower all-cause and CVD mortality risk. In addition, higher sodium-potassium ratio was significantly associated with increased all-cause and CVD mortality. These data provide further evidence to support current public health recommendations in reducing dietary sodium. A simultaneous increase in potassium intake may have additional health benefits.

See Article

One reason chest radiographs are recommended after pneumonia is to rule out underlying lung cancer. Tang et al studied 3398 adults with pneumonia and followed them 5 years. They found that new lung cancer was uncommon, with an incidence of 1% within 90 days and 2% over 1 to 5 years. No lung cancers were detected in those younger than 40 years, and the only major predictor of cancer was age older than 50 years (adjusted hazard ratio, 19.0; P < .001). The authors suggest restricting routine radiographic follow-up of pneumonia to patients older than 50 years because 98% of cancers would still be detected, diagnostic yield would triple, and 40% fewer chest radiographs would be needed.

See Article

Advanced access scheduling, a novel approach to appointment scheduling, has been increasing in popularity as a way to decrease patient wait times, improve continuity, and increase patient satisfaction. While it has been widely implemented in the United Kingdom and the Veterans Health Administration, few large-scale studies have investigated the outcomes of its use. This article systematically reviewed the literature to determine the outcomes of advanced access scheduling. The results were mixed: studies showed that advanced scheduling improves wait times and no-shows but patient satisfaction does not consistently improve. In general, there is a paucity of data on clinical outcomes.

See Article

Approximately 600 US veterans, half of whom were African American, were randomized to either usual care or 1 of 3 telephone-based intervention groups: (1) nurse-administered behavioral management, (2) nurse- and physician-administered medication management, or (3) a combination of both. The intervention telephone calls were triggered based on home blood pressure (BP) values transmitted via telemonitoring devices. Behavioral management involved promotion of health behaviors. Medication management involved adjustment of medications by a study physician and nurse based on hypertension treatment guidelines. Each intervention demonstrated improvements in BP control or systolic BP at 12 months; none of these improvements were sustained at 18 months and did not result in lower medical care costs. However, among those individuals with poor baseline BP control, the combined intervention significantly decreased systolic and diastolic BP at 12 and 18 months. This study indicates the importance of identifying individuals most likely to benefit from potentially resource-intensive programs.

 Image not available.

Estimated systolic BP from baseline to 18 months, by intervention group, for 241 patients with inadequate baseline BP control.

See Article

First Page Preview

View Large
First page PDF preview





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Related Content

Customize your page view by dragging & repositioning the boxes below.