Table of Contents
From the Editor
- The art and evidence of medical practice
A message from the Spine Patient Outcomes Research Trial (SPORT) could be that the artful judgment of a seasoned clinician, with patient input, may actually be a valid way to make decisions.
Medical Grand Rounds
- Colorectal cancer screening lacks evidence of benefit
Although some studies indicate that screening with fecal occult blood testing or colonoscopy prevents deaths from colorectal cancer, the benefits may be offset by more deaths from other causes.
- Chronic hepatitis B virus infection: Issues in treatment
Should we treat all patients with hepatitis B virus infection to prevent liver cancer? Which is the best treatment strategy? What should we do if patients develop resistance to our current drugs? Should we treat patients who already have developed cirrhosis?
Current Drug Therapy
- Modafinil in the treatment of excessive daytime sleepiness
We review the pharmacology, current approved and off-label uses, and side effects of this commonly prescribed wakefulness-promoting agent.
Editorial
- Implications of the Spine Patient Outcomes Research Trial in the clinical management of lumbar disk herniation
What information does the Spine Patient Outcomes Research Trial offer for patients with lumbar radiculopathy and for their clinicians?
Interpreting Key Trials
- Interpreting the Spine Patient Outcomes Research Trial
The Spine Patient Outcomes Research Trial compared surgical and nonsurgical treatment in patients with radicular pain. The treatments were equivalent on intention-to-treat analysis, but up to 40% of patients in each group “crossed over” to the other treatment, muddying the results.
Review
New insights into ischemic heart disease in womenIschemic heart disease appears to be substantially different in women and men, and it is time to devise sex-specific strategies for detecting and assessing it.
Current Drug Therapy
- Atypical antipsychotics: New drugs, new challenges
Second-generation antipsychotic, or atypical, drugs are much less likely than typical antipsychotics to cause movement disorders, but they come with a new variety of side effects, particularly metabolic ones.
