Table of Contents
In This Issue
Editorial
- Treating populations rather than individuals: the subtle danger of managed care
Is managed care improving the quality of health care for populations at the expense of care for individuals?
Medical Grand Rounds
- 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.
- New treatment options for epilepsy
The four newest anticonvulsant drugs— gabapentin, lamotrigine, felbamate, and topiramate—offer some advantages over older agents.
- 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.
Interpreting Key Trials
- Lipid-lowering therapy for average lipid levels: The CARE trial
The CARE findings indicate that average LDL-cholesterol levels are too high in patients with coronary artery disease and can contribute to a reoccurrence of cardiovascular events.
Internal Medicine Board Review
- Preoperative evaluation of a woman with rheumatoid arthritis
What testing and action is needed to prepare this patient for evacuation of a hematoma?
Clinical Reviews
- Management of bite wounds and infection in primary care
Bite wounds can be deceptive, as seemingly minor wounds can result in serious complications, such as septic arthritis.
- What's new in the treatment of hypertension
Systolic pressure predicts risk more accurately than diastolic pressure. The current goal of 140/90 is probably not aggressive enough.
Case Report
- Negative-pressure pulmonary edema: a cautionary tale
Acute pulmonary edema due to upper respiratory obstruction (in this case an endotracheal tube obstructed by dry mucus plugs), may be underdiagnosed.
Cancer Diagnosis and Management
- From serendipity to design: the evolution of drug development in oncology
Although the screening of natural products remains the major method of discovering new anticancer drugs, new techniques of computer-aided drug design and combinatorial synthesis will also play a role.
