Table of Contents
From the Editor
- Up pops the devil
The COMET trial is important for the treatment of heart failure, but the devil is in the details.
Review
- Age-related macular degeneration: Evaluation and treatment
Any patient age 50 or older with vision loss or distorted vision deserves an immediate referral to an ophthalmologist. Hypertension control and smoking cessation are important.
Minimally Invasive Surgery Update
Endovascular therapy or conventional vascular surgery? A complex choiceAortic aneurysms, carotid stenosis, peripheral vascular disease, and stenosis of visceral vessels can now be treated percutaneously, but less invasive isn’t always better.
Review
- BK polyomavirus: A newly recognized threat to transplanted kidneys
An increasing serum creatinine concentration in a kidney transplant recipient should prompt a referral for reevaluation by the transplant center. Among the many possible causes: reactivation of latent BK polyomavirus infection.
Im Board Review
- Skin rash in a transplant patient receiving multiple drugs
He is on heparin, trimethoprim-sulfamethoxazole, cyclosporine, and prednisone. Which one is the culprit, and what should be done?
Review
- Who should be taking aspirin to prevent coronary events?
How to use the estimated coronary risk in deciding whether to prescribe long-term aspirin therapy, with an algorithm and three brief examples.
Interpreting Key Trials
- Interpreting the COMET trial
Although survival was better with carvedilol than with immediate-release metoprolol tartrate, we must increase the use of any approved beta-blocker in heart failure.
Commentary
Patients in cancer trials are not data points; they are vulnerable people who often view a clinical trial as their last hope.