Table of Contents
Highlights from Medical Grand Rounds
- Management of kidney stones: how new technology has affected the indications for intervention
Now that stones can be treated noninvasively on an outpatient basis, intervention is often less expensive and more humane than to "wait and see."
- Enteropathic arthritis
A brief overview of intestinal diseases associated with arthropathy, including ulcerative colitis, Crohn’s disease, dysentery, and Whipple’s disease.
Internal Medicine Board Review
- A pregnant woman with shortness of breath
The authors guide the reader through a challenging diagnosis.
Original Study
- Durability of bipolar coaxial endocardial pacemaker leads compared with unipolar leads
Bipolar coaxial leads are preferable to unipolar leads in most aspects. Yet survival of bipolar coaxial leads in long-term follow-up studies seems worse than that of unipolar leads, indicating the need to reevaluate the risk-benefit ratio of the coaxial design.
- Long-term follow-up of children after repair of atrial septal defects
The authors advocate repair of atrial septal defects as early as possible, definitely "before age 5, in order to minimize long-term complications of left-to-right shunting.
Diabetes Perspective
- Glycemic control and complications of diabetes mellitus: practical implications of the Diabetes Control and Complications Trial (DCCT)
The DCCT results provide new impetus to find better ways to achieve near-normal glycemia.
- Changing the course of diabetic nephropathy: angiotensin-converting enzyme inhibition in type I diabetic renal disease
An overview of the Collaborative Study Group trial, which found that ACE inhibition slows the loss of renal function in diabetes.
Review
- Diagnostic evaluation of the patient with coronary artery disease
Evaluation of patients with possible CAD involves balancing conflicting considerations, such as test sensitivity and accuracy, cost, and access.
Cancer Diagnosis and Management
- Issues in the diagnosis and management of malignant disease
Introduction to a new regular series of succinct reviews of cancer care relevant to non-oncologists.
- Ovarian cancer update: management challenges and advances
Suspicion of ovarian cancer is especially important when working up postmenopausal women with vague abdominal complaints or a palpable ovary.
Current Drug Therapy
- Labetalol and other agents that block both alpha- and beta-adrenergic receptors
A review of how these agents can be used in managing difficult-to-control hypertension.
