Table of Contents
Editorial
- Are calcium antagonists safe?
Recent studies have generated a storm of controversy. A member of the NIH committee on calcium-channel blockers gives his perspective.
Current Drug Therapy
- Methotrexate in rheumatoid arthritis: when NSAIDs fail
With diligent monitoring, low-dose methotrexate is effective for treating selected patients with rheumatoid arthritis, and it is safer than previously thought.
Clinical Review
- Acute dissection of the aorta: options for diagnostic imaging
Although medical therapy should be started as soon as dissection of the aorta is suspected, new imaging methods help confirm the diagnosis.
Symposium: The Internist and Perioperative Care
- The internist as consultant
Ways internists can improve their effectiveness in evaluating patients, managing surgical complications and communicating with referring physicians.
Medical Grand Rounds
- Deep venous thrombosis: low-molecular-weight heparins in perioperative prophylaxis
Although low-molecular weight heparins have theoretical advantages over standard heparin in preventing DVT, the differences in outcome have not been dramatic. The important issue is to give some form of prophylactic therapy.
Internal Medicine Board Review
- Postoperative confusion in a 42-year-old man
Recognizing the cause of postoperative confusion and treating the problem: a self-test
- A 55-year-old man with chronic liver disease and coagulation abnormalities
Assessing the effect of cirrhosis on coagulation and preventing perioperative bleeding: a self-test
Clinical Reviews
- Preoperative screenings What tests are necessary?
Ordering preoperative tests is as easy as checking a form. But what tests are worthwhile for which patients?
- The preoperative bleeding time test: assessing its clinical usefulness
Because of the bleeding time test's low value in predicting perioperative bleeding, it should be abandoned as a routine screening test.
- Perioperative care of the elderly patient: special considerations
For the elderly, surgical risk factors such as underlying disease or the nature of the surgery are more important than age alone. A preoperative assessment can help define risk.
- Evaluating cardiac risk in noncardiac surgery patients
The history, examination, and resting EKG are the cornerstone of cardiac risk assessment, but new techniques are available for questionable cases.
- Postoperative pulmonary complications: risk assessment, prevention, and treatment
Preoperative pulmonary function testing is needed only in high-risk patients; proper management can decrease the risk.
