Table of Contents
From the Editor
- Unproven therapies and media hype
We should be wary of unproven treatments that may he worse than the disease.
1-Minute Consult
Should patients with documented or probable coronary artery disease routinely be placed on beta-blockers before noncardiac surgery?Evidence from randomized, controlled trials indicates that most patients should receive beta-blockers in this situation.
- Can fibromyalgia and chronic fatigue syndrome be cured by surgery?
The hypothesis is interesting, hut data are lacking.
- Should an ACE inhibitor be stopped if signs of renal insufficiency appear?
One must consider the magnitude of the decline and the expected benefits of continuing the medication.
Medical Grand Rounds
- Performance-enhancing substances: What athletes are using
Use of performance-enhancing substances is widespread, even among amateur athletes. Here is a rundown of the effects, legal status, and potential for abuse of some of the more common substances.
- Falls in elderly patients: Predictable and preventable
Falls in the elderly are not random occurrences caused solely by bad luck—they are predictable. And what can be predicted can often be prevented.
- Finding evidence-based answers to clinical questions online
You can quickly find answers to medical questions online. The key is to be selective, based on the type of information needed.
- Legionnaires’ disease: Seek and ye shall find
Contrary to popular opinion, Legionnaires’ disease is common. New tests for it will make people realize just how common it is.
Infection Control
- Handwashing compliance: What works?
Compliance with handwashing guidelines rarely exceeds 50%, and physicians are the worst offenders. Plain soap and water may not be enough.
Review
- Immunizations in adult immunocompromised patients: Which to use and which to avoid
Immunocompromised patients are particularly susceptible to infectious diseases, but they may not always receive the vaccines they need for protection.
- Safe use of sildenafil in patients with coronary artery disease
Despite reports of myocardial infarction and sudden cardiac death in men taking sildenafil (Viagra), most evidence indicates the drug is safe, effective, and well tolerated in most men with coronary artery disease.
- Dofetilide (Tikosyn): A new drug to control atrial fibrillation
The pharmacology of dofetilide, the evidence of its effectiveness, and the appropriate precautions in using it.
