Table of Contents
Highlights from Medical Grand Rounds
- Chronic Fatigue and Immune Dysfunction
Recent advances in the understanding of the syndrome of chronic fatigue and immune dysfunction facilitate diagnosis and treatment of specific subsets of patients.
- Assessing New Techniques in Coronary Angioplasty
A cardiologist describes how two new techniques were integrated into everyday practice.
CME Notebook
Review
- Sleep in the patient with lung disease
How to recognize and manage the ill effects that sleep-related respiratory changes can have on underlying lung disease, including COPD, asthma, and interstitial lung disease.
- Survivors of sudden cardiac death: a rational approach to evaluation and therapy of patients surviving ventricular fibrillation
A strategy for identifying underlying disease, stratifying the risk of recurrence, and formulating specific therapy in these patients, at high risk for life-threatening ventricular tachyarrhythmias.
- Indications for electrophysiologic study in patients with ventricular arrhythmias
An analysis of current guidelines for the use of electrophysiologic study, and a look at practical applications.
- The phenomenal growth of laparoscopic cholecystectomy: a review
Touted by surgeons who perforin it and demanded by a public attracted by claims of reduced pain and fast recovery, laparoscopic cholecystectomy is taking the United States by storm. The authors provide insight into the appropriate use of this operation.
Current Drug Therapy
- The hemodynamic effects of adrenergic blocking agents
Alpha-1 blockers may suit patients with active life-styles, peripheral vascular disorders, or high blood-cholesterol levels, while beta blockers are useful in tachycardia, palpitations, or angina pectoris. An overview of the pharmacologic qualities and numerous clinical applications of these agents.
Case Report
- Catheter ablation for recurrent ventricular tachycardia
Successful use of this procedure is described in a 78-yearold man with drug-refractory ventricular tachycardia who had both an implantable cardioverter-defibrillator and an antitachycardia pacemaker.
- Annular pancreas and intermittent duodenal obstruction in an alcoholic adult
This congenital condition, in which pancreatic tissue encircles the middle portion of the duodenum, may not cause symptoms until adulthood, as was the case in this 49-year-old man.
Radiology Pathology Grand Rounds
- Mental status changes in an immunocompromised patient
A young patient with Burkitt’s lymphoma and acute lymphoblastic leukemia was found unarousable following 3 days of forgetfulness and expressive nominal aphasia.
