Table of Contents
Internal Medicine Board Review
- Chest pain in a patient with congenital heart disease
A self-test featuring a challenging clinical presentation.
Highlights from Medical Grand Rounds
- Managing acetaminophen overdose
Alcohol and certain drugs potentiate the hepatotoxic effects of this common, over-the-counter analgesic. Treatment with acetylcysteine and, possibly, Cimetidine can prevent irreversible liver damage.
- Identifying early markers of type II diabetes
Earlier identification of people at risk may permit intervention with diet and exercise to prevent NIDDM.
Clinical Review
- Dopamine agonists in the treatment of Parkinson’s disease
Bromocriptine or pergolide can control symptoms when used alone or as an adjunct to Levodopa therapy, and can permit a lowering of the levodopa dose.
- Oral disease in the geriatric patient: the physician’s role
By being alert for common oral problems, physicians can help their elderly patients maintain function and quality of life.
- Current status of stress echocardiography in the diagnosis of coronary artery disease
Electrocardiography with exercise or pharmacologic stress is gaining clinical acceptance, but its accuracy depends on the expertise of the people who perform it.
- Stress echocardiography: its emerging role in identifying viable myocardium
In patients with chronic ischemia or left ventricular systolic dysfunction, this test can indicate whether the damaged myocardium is still viable and, therefore, whether revascularization would be beneficial.
- Pathogenesis of epilepsy: the role of excitatory amino acids
These neurotransmitters seem to play a role in brain development—and also in seizures. Experimental drugs can block their action.
Current Drug Therapy
- Drugs for the prevention and treatment of acute renal failure
Mannitol, loop diuretics, dopamine, and calcium antagonists show promise, but they have not yet been rigorously tested for this indication. Caution is advised.
Cancer Diagnosis and Management
- Trends in radiation oncology: a review for the non-oncologist
One hundred years after the first radiation treatment, technical improvements continue, with more-powerful machines and more-precise planning.
Editorial
- Caring for dying patients: physicians and assisted suicide
Both advocates and opponents can agree on the need for better palliative care.
