ACP American College of Physicians - Internal Medicine - Doctors for Adults

September/October 2001

ORIGINAL ARTICLES

Cardiologists Performing Peripheral Angioplasties: Impact on Utilization

David A. Axelrod, A. Mark Fendrick, David E. Wennberg, John D. Birkmeyer, and Andrea E. Siewers

Peripheral angioplasty and stent placement have traditionally been done by radiologists and surgeons. However, an increasing number of cardiologists are beginning to perform these procedures. Rates of these procedures are highest in regions where cardiologists do most of the angioplasties.
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Intensive Care Unit Nurse Staffing and the Risk for Complications after Abdominal Aortic Surgery

Peter J. Pronovost, Deborah Dang, Todd Dorman, Pamela A. Lipsett, Elizabeth Garrett, Mollie Jenckes, and Eric B. Bass

Efforts to reduce the cost of hospital care have resulted in decreased nurse-to-patient ratios. However, having fewer ICU nurses per patient is associated with increased risk for respiratory-related complications after abdominal aortic surgery, which calls this practice into question.
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ORIGINAL ARTICLES

Physician Explanations for Failing To Comply with "Best Practices"

Christel Mottur-Pilson, Vincenza Snow, and Kyle Bartlett

Noncompliance with best practices for diabetes is common, even among a self-selected group of physicians. Although some external factors do play a role in noncompliance, it also may result from a conscious decision, as physicians may disagree about what constitutes "best practices."
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BACK OF THE ENVELOPE

Balancing the Benefits of Primary Angioplasty against the Benefits of Thrombolytic Therapy for Acute Myocardial Infarction: The Importance of Timing
David M. Kent, Joseph Lau, and Harry P. Selker

Clinical trials with short angioplasty-related delays have shown that angioplasty resulted in better outcomes, whereas trials with longer delays favored thrombolytic therapy. A more precise estimate of the time interval to equipoise between the two therapies based on patient-level data is needed.
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EDITORIALS

Increases in Peripheral Interventional Procedures by Cardiologists—Are Patients or Providers Being Served?
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More Nurses, Better Patient Outcomes: Why Isn't It Obvious?
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Treatment Delay in Myocardial Infarction: A Timely Topic
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PRIMERS

95% Confidence Intervals
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Geographic Variation in Health Care
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MARKETING MEDICINE

Promoting a "Community Wellness" Program
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CORRECTION
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LETTERS TO THE EDITOR

Breast Cancer Coverage in Magazines: Misleading or Motivating?
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Prescribing Antibiotics: Seeing the Whole Picture
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