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UNTIL 5 P.M., EST,
MONDAY, MARCH 31, 1997
April 1, 1997, Tip Sheet
Annals of Internal Medicine is published by the American College of
Physicians (ACP), more than 100,000 physicians
trained in internal medicine. The following
highlights are not intended to substitute
for articles as sources of information. For a
copy of an article, call 1-800-523-1546, ext. 2656
or 215-351-2656.
* * *
Dietary Calcium Decreases Risk for Kidney Stones in Women
High intake of dietary calcium appears to
decrease risk for symptomatic kidney stones
in women, whereas intake of supplemental calcium,
for example, in tablet form, may increase risk,
a study shows. (Article, p. 497.) This prospective
cohort study with a 12-year follow up suggests
the different effects caused by the type of
calcium may be related to consuming calcium at the
same time as consuming oxalate, or other factors
in dairy products could be responsible for the
decreased risk seen with dietary calcium.
An editorial examines why physicians should not
restrict dietary calcium intake as a preventive or
therapeutic measure in patients at risk for
kidney stone formation. (Editorial, p. 463.)
* * *
Risk Stratification After Myocardial Infarction
ACPs guidelines on risk stratification after myocardial infarction
have been updated in response to increased
availability of data from randomized clinical
trials, diagnostic and interventional
technologies and the growth of managed care
organizations. The paper highlights the four major
stages in the hospitalization of patients with acute
myocardial infarction and outlines risk
stratification processes that should occur during
each stage. (Position Paper, p. 556.)
The background paper on which ACP guidelines are
based reviews literature on risk stratification
after acute myocardial infarction and proposes
an algorithm for early and continual risk assessment.
(Clinical Guideline, p. 561.)
Many, but not all, patients benefit from
angiography and angioplasty after
myocardial infarction, a study shows. (Review, p.
539.) A review assesses the data that support the
selective use of these procedures, identify
risks, and analyze use and costs.
An accompanying editorial examines evidence-based
coronary care. (Editorial, p. 465.)
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