0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
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. 2006;166(4):387. doi:10.1001/archinte.166.4.387.
Text Size: A A A
Published online

TRANSITIONS BETWEEN FRAILTY STATES AMONG COMMUNITY-LIVING OLDER PERSONS

Frailty is increasingly recognized as a geriatric syndrome, distinct from disability and comorbidity, but relatively little is known about its natural history. In this prospective study, which included assessments of frailty at 18-month intervals among 754 community-living older persons, Gill et al found that frailty is a dynamic process, characterized by frequent transitions between frailty states over time. Transitions to states of greater frailty were more common than transitions to states of lesser frailty, and the probability of transitioning from being frail to nonfrail was very low, even over an extended period. These results suggest ample opportunity for the prevention and remediation of frailty.

See Article

NEUTROPENIA IN HUMAN IMMUNODEFICIENCY VIRUS INFECTION

The Women's Interagency HIV Study (WIHS) examines the characteristics of human immunodeficiency virus (HIV) in women. Levine et al studied the correlates of neutropenia in the HIV-infected women enrolled in the WIHS and found that development of neutropenia was associated with worsening HIV disease parameters, such as increasing HIV viral load and decreasing CD4 cell count. Improvements in HIV disease parameters were associated with resolution of neutropenia, as was the use of highly active antiretroviral therapy. In addition, the use of highly active antiretroviral therapy without zidovudine was associated with protection against developing neutropenia. Neutropenia was not associated with decreased survival among HIV-infected women.

See Article

METABOLIC SYNDROME AND THE PROGRESSION OF CAROTID INTIMA-MEDIA THICKNESS IN ELDERLY WOMEN

The aim of the study was to investigate the association of incident metabolic syndrome with the progression of carotid intima-media thickness, a noninvasive measure of atherosclerosis, during 12 years in 101 women aged 60 to 70 years at baseline. The results show that incident metabolic syndrome is associated with accelerated progression of carotid atherosclerosis in elderly women, independent of traditional risk factors.

See Article

COCOA INTAKE, BLOOD PRESSURE, AND CARDIOVASCULAR MORTALITY

Short-term intervention studies show that large amounts of dark chocolate and cocoa drinks improve endothelial function and reduce blood pressure (BP), but results of observational studies have not been published thus far. In this population-based study conducted in 470 Dutch elderly men, the intake of cocoa from the habitual consumption of cocoa-containing foods was investigated cross-sectionally with BP and prospectively with cardiovascular mortality. Buijsse et al report that cocoa intake is related to an approximately 3.5 mm Hg lower systolic and 2.0 mm Hg lower diastolic BP. After 15 years of follow-up, comprising 314 deaths, cocoa intake was also associated with a 45% to 50% lower risk of cardiovascular and all-cause mortality. This study suggests that habitual daily intake of cocoa reduces both BP and the risk of death from cardiovascular diseases and all causes.

See Article

CONTRIBUTION OF INFECTION TO INCREASED MORTALITY IN WOMEN AFTER CARDIAC SURGERY

Women have a greater risk of in-hospital mortality compared with men after coronary artery bypass graft surgery. Rogers et al examined the role of infection in this relationship by following 9218 Michigan Medicare beneficiaries hospitalized for cardiac surgery. They obtained information regarding infection at any site using International Classification of Diseases, Ninth Revision codes and assessed mortality in the 100-day period after the date of surgery. Women were more likely than men to have an in-hospital infection. However, the risk of death with infection was greater in men than in women. Using population attributable risk, the authors show how these 2 opposing, underlying associations contribute to the overall excess number of deaths in women.

Place holder to copy figure label and caption
Percentage of deaths attributable to female sex by length of stay and by adjustment for infection.
Graphic Jump Location

See Article

Figures

Place holder to copy figure label and caption
Percentage of deaths attributable to female sex by length of stay and by adjustment for infection.
Graphic Jump Location

Tables

References

Correspondence

CME
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.
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.
Submit a Comment

Multimedia

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

Related Content

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