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Bugiardini and colleagues provide data on the 1-year follow-up in a group of 710 patents with non–ST-segment elevation–acute coronary syndromes and nonobstructive coronary disease. The results demonstrate a wide range of outcomes. The majority of events were driven by repeated admission for unstable angina (10.1%). However, the mean risk was high even for death and myocardial infarction (2.1%). The Thrombolysis in Myocardial Infarction core risk proved to have a good discriminating power for death and myocardial infarction also in this group of patients (from 0.6% to 4.1%).
Guidelines from the American College of Physicians and the Infectious Diseases Society of America differ regarding the best way to evaluate adults with pharyngitis, mainly for adults with a high probability of having streptococcal pharyngitis. Despite this controversy, this retrospective analysis found that clinicians failed to follow either guideline in 66% of visits, mainly through indiscriminant testing and prescribing antibiotics to adults at low risk for streptococcal pharyngitis, patients for whom the guidelines agree. The authors conclude that the major problem in the management of adults with pharyngitis is not which guideline to follow, but that clinicians failed to follow any guideline.
In This Issue of Archives of Internal Medicine. Arch Intern Med. 2006;166(13):1341. doi:10.1001/archinte.166.13.1341
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