Table of Contents
From the Editor
- Follow the evidence—but don’t expect a straight path
The newest data on hormone replacement therapy remind us that evidence-based practice is not cookbook medicine.
1-Minute Consult
Is there a relationship between hypertension and cognitive function in older adults?Yes, and there is some evidence that treating hypertension protects against cognitive decline later in life.
Medical Grand Rounds
- The case for hormone replacement: New studies that should inform the debate
Unfortunately, many women who might benefit from hormone replacement may decide to forgo it.
Patient Information
Editorial
- Hormone replacement therapy: Applying the results of the Women’s Health Initiative
The ground rules have changed for prescribing hormone replacement therapy. Here are one expert’s recommendations.
Heart Valve Update
- Choosing the most appropriate valve operation and prosthesis
Should the valve be repaired or replaced? And if replaced, which prosthesis is best?
Review
What internists need to know about postpolio syndromePolio may be eradicated soon, but at least 1 million polio survivors in the United States are at risk of developing postpolio syndrome.
Interpreting Key Trials
- The ACUTE Trial
A TEE-guided approach showed no advantage over conventional management in rates of embolic events, but shortened the anticoagulation course, allowed for earlier cardioversion, and caused fewer bleeding events.
The Clinical Picture
- The crystal, the gout, and the paradox
We think we know what causes gout, but things may not be so simple.
Review
- Advances in diagnosing and excluding pulmonary embolism: Spiral CT and D-dimer measurement
No test is 100% sensitive and specific for pulmonary embolism. The best approach still depends on the pretest probability and, thus, on clinical judgment.
Medical Grand Rounds
- Acute stroke therapy: Beyond IV tPA
The quest to improve treatment includes intra-arterial infusion of thrombolytics, mechanical interventions, and neuroprotection through hypothermia.
