Annals of Internal Medicine tip sheet for Nov. 15, 2005, issue

November 14, 2005

1. New Study: Condom Use Reduces Incidence of Genital Herpes

A study of 1,843 people at high risk for herpes infection found that those who used condoms more frequently had lower rates of herpes simplex virus-2 (HSV-2) (Article, p. 707).

An editorial writer says that while ongoing efforts seek to promote sexual abstinence, reduce risk-taking behaviors, and develop a vaccine and/or other preventive drug, "condoms remain the best proven currently available means to reduce the risk for STDs [sexually transmitted diseases] in at-risk persons." (Editorial, p. 751)

2. Blood Clot Problems in Pregnancy and Soon Thereafter Are Infrequent but Can be Life-threatening

Pregnant women and women in the three months following delivery had four times more blood clot problems, including deep vein thrombosis and pulmonary embolism (together often called venous thromboembolism) than nonpregnant women in the same age range, a new study finds (Article, p. 697). These rates are higher than previously published estimates.

Researchers looked at records of 50,000 women who were pregnant between 1966 and 1995. One hundred developed deep vein thrombosis, pulmonary embolism, or both. The incidence of venous thromboembolism increased with each trimester of pregnancy and was highest in the postpartum period. In the postpartum period, the incidence of pulmonary embolism, in which a blood clot breaks loose and lodges in the lungs, was 15 times higher than during the pregnancy itself. Older mothers in the first weeks after delivery had the highest risk for pulmonary embolism.

An editorial writer says that, however rare, during the last 20 to 30 years pulmonary embolism has become the leading cause of maternal death in the United States (Editorial, p. 749).

Although the study highlights the importance of the postpartum period in development of venous thromboembolism, the writer says, physicians need stronger evidence and more specific risk profiles before prescribing anticoagulant therapy for pregnant and postpartum women.

3. Nurse Practitioners, P.A.s Provide Similar Quality of HIV Care as Physician HIV-Experts and Better Than Non-HIV-Expert Physicians
(Improving Patient Care, p. 729)
Annals of Internal Medicine is published by the American College of Physicians. These highlights are not intended to substitute for articles as sources of information.

American College of Physicians

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