Table of Contents
From the Editor
- Antibiotic prophylaxis: Is prevention always worth the cost and risk?
When hard data are lacking we err on the side of caution and consensus.
Editorial
- Culture, race, and disparities in health care
Cultural competence isn’t about “political correctness." It’s about people’s health.
Review
- Physician cultural competence: Cross-cultural communication improves care
Your patients culture makes a difference in his or her care—and so does your own.
Interpreting Key Trials
- Initial Findings of the AASK
In a major study, an ACE inhibitor slowed the decline of renal function better than a calcium channel blocker.
Review
- Penicillin allergy: Consider trying penicillin again
With skin testing and, in some cases, desensitization, most patients with a history of penicillin allergy can safely receive drug.
1-Minute Consult
- What is the target TSH level in thyroid hormone replacement for primary hypothyroidism?
My goal is between 0.4 and 3.0, at the low end of the normal range.
Medical Grand Rounds
- Using BNP to diagnose, manage, and treat heart failure
The BNP assay can help guide treatment from diagnosis to hospital discharge. Synthetic BNP is an important new drug.
Review
- Preventing kidney failure: Primary care physicians must intervene earlier
Five simple questions can help one to intervene early and effectively, using just a few minutes of an office visit.
- Chemoprevention of colorectal cancer: Slow, steady progress
We are learning how to use aspirin and other drugs to prevent colorectal cancer, or at least reduce its incidence.
1-Minute Consult
- Do patients with total joint replacements need antibiotics before dental work?
Opinions vary, but I recommend an antibiotic for patients with prosthetic joints who have rheumatoid arthritis or other risk factors before dental procedures known to induce bleeding.
Review
- DXA scanning to diagnose osteoporosis: Do you know what the results mean?
Behind the numbers on the report lurk many opportunities for error, and the results depend on the operator and scanner used.
- Practical tips for warfarin dosing and monitoring
Patients on warfarin walk a tightrope between bleeding and clotting—and a hundred things can tip the balance.