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. 2007;167(21):2282. doi:10.1001/archinte.167.21.2282.
Text Size: A A A
Published online

Data from the Black Women's Health Study were used to evaluate the relationship of glycemic index, glycemic load, and cereal fiber with risk of type 2 diabetes. During 8 years of follow-up, there were 1938 incident cases of diabetes. Glycemic index was positively associated with risk of type 2 diabetes, and cereal fiber intake was inversely associated with risk of type 2 diabetes. Stronger associations were seen among those women who were not overweight. The authors conclude that increasing dietary cereal fiber may be an effective method of reducing risk of type 2 diabetes in black women.

See Article

Although human immunodeficiency virus (HIV) testing can improve care for many critically ill patients, state laws and institutional policies generally bar testing when patients cannot consent. In this survey of US academic intensivists, Halpern et al found that 77% had encountered decisionally incapacitated patients for whom HIV testing was desired; 22% of these pursued nonconsented HIV tests, while 62% first obtained surrogate consent. Intensivists who believed that nonconsented HIV testing was ethical and those who believed that their states allowed nonconsented testing when medically necessary were more likely to pursue nonconsented HIV tests, but actual state laws were unrelated to testing practices. Halpern et al also found that when intensivists are unable to obtain HIV tests, they frequently rely on surrogate markers of infection, despite the fact that these markers are poor indicators of HIV status in the critically ill.

See Article

In this randomized controlled trial by Grover et al, 230 primary care physicians from across Canada enrolled 3053 patients with treatable dyslipidemia to receive ongoing feedback regarding their calculated coronary risk or usual care. After 12 months of follow-up, greater mean reductions in low-density lipoprotein cholesterol levels and the total cholesterol to high-density lipoprotein cholesterol ratio were observed among subjects receiving risk profiles (51.2 and 1.5 mg/dL) vs usual care (48.0 and 1.3 mg/dL). The differences were small but significant (−3.3 mg/dL and −0.1 mg/dL, respectively). Risk profile patients were also more likely to reach lipid targets (odds ratio, 1.26), and a significant (P = .04) “dose-response effect” was noted when the impact of the risk profile was strongest (odds ratio, 1.69) among those with the worst profiles. Informing a patient of his or her coronary risk is associated with a measurable improvement in the efficacy of lipid therapy.

See Article

Ortega et al used the California Health Interview Survey to study health care access, utilization, and experiences for 1317 undocumented Mexicans and 271 undocumented other Latinos vs 2851 US-born Mexicans and 852 US-born other Latinos, as well as 1218 naturalized Mexicans, 546 naturalized other Latinos, 1352 Mexicans, and 327 other Latinos with green cards. Undocumented Mexicans and other Latinos had fewer physician and emergency department visits compared with their US-born counterparts. Both undocumented groups were less likely to report difficulty obtaining necessary health care than their US-born counterparts. Undocumented Mexicans were less likely to have a usual source of care and were more likely to report negative experiences with care compared with US-born Mexicans.

See Article

To investigate whether depressive or anxiety symptoms are associated with hospitalizations and mortality in patients with chronic obstructive pulmonary disease (COPD), Fan et al examined data from patients with severe COPD who participated in the National Emphysema Treatment Trial. In a prospective cohort study of 610 patients randomized to medical therapy, the authors found that depressive symptoms, measured with the Beck Depression Inventory, were common and that the majority of patients were not being treated with antidepressants. Depressive symptoms were associated with a significantly increased adjusted risk for 3-year mortality (odds ratio, 2.26) but were not associated with risk of hospitalizations after adjustment for disease severity. Anxiety symptoms did not increase the risk of either hospitalizations or mortality. This suggests that a further understanding of depression in COPD may help to target therapies to reduce mortality.

See Article




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.