More articles from Medical Grand Rounds
- Can the patient make treatment decisions? Evaluating decisional capacity
Evaluations of a patient's ability to make treatment decisions are common in everyday practice. Dr. Agich reviews the standards for evaluating decisional capacity.
- Low back pain: Living with ambiguity
Ambiguity is a fact of life in treating acute low back pain, frustrating physicians and patients alike.
- Is intensive glycemic control worth the expense?
Is tight control of glucose levels cost-effective for type I diabetes? And what about type II diabetes?
- Evaluating adrenal incidentalomas
Adrenal incidentalomas are detected on approximately 1% to 2% of all abdominal CT scans. The question is, how clinically significant are they?
- Disturbing asthma statistics reflect suboptimal management
Beta agonists are used too often and inhaled steroids too little. Leukotrine receptor antagonists will be an important new asthma therapy, but allergy shots remain controversial.
- Beyond statistics: What is really important in medicine?
Clinicians should apply clinical reasoning when interpreting trial results, and researchers should find better ways of measuring “soft” outcomes, such as quality of life.
- New treatment options for epilepsy
The four newest anticonvulsant drugs— gabapentin, lamotrigine, felbamate, and topiramate—offer some advantages over older agents.
- The constitutionality of physician-assisted suicide: the cases and issues before the US Supreme Court
How the Court rules on physician-assisted suicide will spur further legal debate for decades.
- Reperfusion for acute myocardial infarction: 1997 and beyond
The optimal thrombolytic therapy will be a cocktail of several thrombolytic, antithrombotic, and antiplatelet agents, each of which attacks different pathways of clot formation.
- Smoking and the complications of diabetes mellitus
Even though persons with diabetes have more to gain from quitting smoking than those without diabetes, the prevalence of smoking in the diabetic population is surprisingly high.