Table of Contents
From the Editor
- A drug, a concept, and a clinical trial on trial
The ENHANCE trial, evaluating the addition of a second hypocholesterolemic drug (ezetimibe) to a statin using two surrogate end points in a relatively small number of patients, hit the national news when the two surrogates didn’t match up.
The Clinical Picture
- Generalized pruritus after a beach vacation
A 25-year-old man presents with a 2-month history of generalized itching that began 5 weeks after a trip to Brazil, during which he had sexual relations without protection. What is the most likely diagnosis?
Editorial
- Given the ENHANCE trial results, ezetimibe is still unproven
We should beware of explaining away results that do not match our expectations.
Review
- Bacterial conjunctivitis: A review for internists
It is critical to differentiate bacterial conjunctivitis from other types of conjunctivitis and more serious vision-threatening conditions so that patients can be appropriately treated and, if necessary, referred to an ophthalmologist.
- Perioperative beta-blockers in noncardiac surgery: Evolution of the evidence
The pendulum of opinion is swinging away from routinely recommending beta-blockers to prevent cardiac events in surgical patients. We will probably be using them more selectively than in the past.
Blood smear analysis in babesiosis, ehrlichiosis, relapsing fever, malaria, and Chagas diseaseBlood smear analysis should be performed in patients with persistent or recurring fever, those who have traveled to the developing world, or those who have a history of tick exposure, especially if accompanied by hemolytic anemia, thrombocytopenia, or hepatosplenomegaly.
- From the Children’s Oncology Group
Children who undergo radiotherapy, chemotherapy, or surgery for cancer face a risk of complications later in life, including pulmonary fibrosis and pneumonitis. They need systematic, lifelong surveillance.
The Clinical Picture
- Dyspnea, arthralgias, and muscle weakness
A computed tomographic scan shows ground-glass opacities in the lower lobes of both lungs. What is the most likely cause of this patient’s symptoms and radiographic findings?
Departments
- VTE prevention in major orthopedic surgery (Supplement 3 to Volume 75, April 2008)
Venous thromboembolism prevention in major orthopedic surgery.
Commentary
The impact of the ENHANCE trial reveals more about the political climate than it does about the effects of ezetimibe on the progression of atherosclerosis.