Table of Contents
From the Editor
- When and Why to Consider Estrogen Therapy
Estrogen replacement therapy in postmenopausal women reduces the risk of osteoporosis and cardiovascular disease. Yet only 14% of postmenopausal women who could benefit from estrogen therapy are receiving it.
- Differentiating Among Renal Stones
Recognizing the signs and symptoms of each type of renal stone disease provides clues to the underlying metabolic derangement and enables prompt intervention to reduce the chance of recurrence.
CME Notebook
Brief Communication
- Circulating lipid and lipoprotein concentrations with oral estrogen-androgen hormone replacement therapy
A decrease in high-density lipoprotein cholesterol was observed in a group of postmenopausal women following oral estrogen-androgen therapy, suggesting that the potential benefits—sexual and psychological well-being— should be weighed against the potential cardiovascular risks associated with adverse lipid changes.
Review
- Doppler echocardiographic assessment of aortic regurgitation: uses and limitations
The final determination of the severity of aortic regurgitation should involve a combination of the various Doppler techniques and the indices derived from them.
- Gardner’s hydrodynamic theory of syringomyelia revisited
How longitudinal, fluid-filled cavities form within the spinal cord has eluded researchers, though widely espoused theories have been put forth. The authors propose a unified theory based on recent MRI experience and on elements of other current theories.
- Prostate cancer: current concepts in diagnosis and treatment
Controversy persists over how best to screen the general population for prostate cancer, and whether earlier detection decreases mortality. The author outlines an approach to screening, diagnosis, and treatment grounded on A U A guidelines and clinical experience.
- Viral hepatitis in the 1990s, part II: hepatitis B and delta virus
Effective vaccines are available. High-risk groups have been identified. But widespread prevention of hepatitis B infection remains an elusive goal, and key questions need answers: What are the mechanisms of transmission, including mother-to-offspring transmission? What short - and long-term risks do health care professionals face?
- Tools for noninvasive assessment of coronary arterial reperfusion
Coronary angiography has been the standard method to rapidly assess coronary reperfusion status after acute MI, but the availability, cost, and risks of the procedure are potential concerns. Noninvasive markers are showing promise as alternatives to angiography.
Contributions
- Primary pulmonary hypertension, then and now: 28 years of experience
Patients with PPH are presenting at earlier stages of the disease, have fewer complications during cardiac catheterization, and probably survive longer after diagnosis than patients seen several decades ago.
Case Report
- Benign intracranial hypertension and chronic renal failure
Chronic renal failure of unknown etiology is described in a patient with new-onset headache, papilledema, and intracranial pressures between 200 and 400 mm H2O.
- Diabetic ketoacidosis associated with pheochromocytoma
Diabetic ketoacidosis associated with classic findings of pheochromocytoma was seen in a young woman who also had a significant insulin requirement that resolved after excision of the tumor.
Radiology Pathology Grand Rounds
- Pelvic retroperitoneal mass in a 36-year-old man
The mass identified by CT extended into the pelvis and displaced the bladder, rectosigmoid colon, and rectum. Hydronephrosis with marked parenchymal loss of the left kidney indicated chronic obstruction of the left distal ureter.
