Table of Contents
From the Editor
- ECT: Bad reputation, but often effective
It may come as a surprise that psychiarists still use electroconvulsive therapy. Books and movies have not portrayed it in a flattering light.
Point and Counterpoint
- Interpreting the Courage Trial
We are fortunate to have a point-counterpoint between Dr. William Boden, the principal investigator of the Clinical Outcomes Utilizing Percutaneous Coronary Revascularization and Aggressive Drug Evaluation (COURAGE) trial, and Dr. Dean Kereiakes, a leading interventional cardiologist.
Point
- Interpreting the Courage Trial
We found that as an initial management strategy in patients with stable coronary artery disease, percutaneous coronary intervention did not reduce the incidence of death, myocardial infarction, or other major cardiovascular events when added to optimal medical therapy.
Counterpoint
Perspective
- Screening for coronary heart disease: Has the time for universal imaging arrived?
Screening for coronary heart disease by means of an imaging test is not supported by evidence and is not endorsed by professional societies or the US Preventive Services Task Force.
Medical Grand Rounds
- Ulcerative colitis: Responding to the challenges
Aminosalicylates are the first-line therapy for patients with mild to moderate active ulcerative colitis. Infliximab is now approved for moderately to severely active ulcerative colitis in patients who have had an inadequate response to conventional therapy.
Review
- Managing knee osteoarthritis before and after arthroplasty
Primary care physicians play a key role in the diagnosis and nonoperative management of knee osteoarthritis, including monitoring for problems in patients who have undergone knee replacement surgery.
Medical Grand Rounds
- Hypertension from Framingham to ALLHAT: Translating clinical trials into practice
Most people with hypertension are still not being adequately treated. Newer drugs have not surpassed diuretics in efficacy and safety. Rather than trying to develop newer, more expensive agents, our priority should be to treat more patients and to treat them more aggressively.
Review
- Electroconvulsive therapy: What the internist needs to know
Despite its bad reputation, electroconvulsive therapy is safe and effective for treating a number of psychiatric disorders. For some patients, it is the only therapy that works.