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 syndrome
Polio 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.