More articles from 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.
- 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?
- 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.
- Cardiovascular medicine update 2007: Perioperative risk, carotid angioplasty, drug-eluting stents, stronger statins
Should patients with coronary artery disease who need noncardiac surgery undergo angioplasty first to lessen their perioperative risk? Is percutaneous carotid angioplasty an acceptable alternative to open surgery? Are drug-eluting stents safe in the long term? What is the best regimen and goal for managing lipid levels in patients with coronary artery disease?
- Viral infections and the kidney: HIV, hepatitis B, and hepatitis C
Ten years ago, viral glomerulonephritis was usually regarded as untreatable. Now treatments are available for the top three causes: HIV, hepatitis B, and hepatitis C.
Recognizing and managing fibromuscular dysplasiaMany physicians consider fibromuscular dysplasia to be rare, but it is not that uncommon: it is simply often overlooked or misdiagnosed.
- Better glycemic control in the hospital: Beneficial and feasible
Professional societies have issued consensus guidelines urging hospitals to tackle hyperglycemia in an organized fashion, and hospitals are taking up the challenge.
- The effect of obstructive sleep apnea on chronic medical disorders
Evidence is mounting that obstructive sleep apnea causes or contributes to many chronic medical diseases, and that treatment with continuous positive airway pressure often improves the concomitant diseases.
- Role of uric acid in hypertension, renal disease, and metabolic syndrome
Clinical gout is just the tip of the iceberg: we believe that elevated uric acid is actually one of the most important risk factors for cardiovascular disease and that it plays a role in renal disease and metabolic syndrome as well.
- Endocrinology update 2006
Recent studies have shed light on diabetes management, the therapeutic range of thyroid hormones, the possible role of thyroxine in cancer, and the possible role of vitamin D in preventing type 1 diabetes.