Skip to main page content
This study suggests that some patients with severe acute respiratory syndrome do not present with respiratory symptoms even though they have lung infiltrates. Advanced age and high initial serum lactate dehydrogenase level predict mortality.
Patients with osteoarthritis of the knee have reduced symptoms for at least 1 week after application of leeches. The pharmacologic properties of leech saliva that are responsible for this effect are not known.
Increasing systolic blood pressure increases all-cause and cardiovascular mortality over a wide range of blood pressure. In older people, the relationship of diastolic blood pressure to mortality is J-shaped. Therefore, the association of pulse pressure with mortality is complex, which makes it less useful as a guide to treatment or prognosis.
Vulnerable older people do not receive adequate care for many conditions. Care for geriatric conditions is much less likely to be optimal than care for general medical conditions.
Paradoxical thromboembolism through a patent foramen ovale may be an important mechanism of cryptogenic stroke. This review shows that transcatheter closure of a patent foramen ovale is associated with a lower rate of recurrent stroke than treatment with antiplatelet agents or warfarin anticoagulation.
Increased recognition of specific causes of hypertension may lead to therapies that address specific pathophysiologic mechanisms and cause fewer adverse effects. Research to identify such therapies will use powerful new techniques of genetics, genomics, and proteomics in conjunction with systems physiology and population studies.
In the recent Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT), the incidence of the primary end point was identical in the chlorthalidone, lisinopril, and amlodipine groups. The authors based their widely publicized major conclusion—that thiazide diuretics are the preferred first-line antihypertensive therapy—solely on secondary end points and cost.
Although future studies might show that leech therapy is a practical, effective therapy for osteoarthritis of the knee, the work by Michalsen and colleagues in this issue is most exciting precisely because it raises the possibility of a novel, analgesic agent that could be safely administered without the need for a leech bite.
In this issue, Wenger and colleagues found that preventive care, chronic care, and care of geriatric conditions in U.S. vulnerable elders are often suboptimal. We need to focus much more attention on medical care for the most vulnerable third of the older population. Reimbursement practices must change so that they support practice patterns necessary to provide such care.
Khairy and colleagues' review of uncontrolled studies suggests that closure of a patent foramen ovale is associated with a lower rate of recurrent stroke than treatment with antiplatelet agents or warfarin anticoagulation. Proving this point will require a prospective controlled clinical trial.
He didn't feel very likable when he was on call. He must have made his family just as miserable as he made himself, since they seemed to dread his call days almost as much as he did. This call day was unexpected, and he was grateful that he hadn't had time to dread it.
This Update discusses cardiac arrest, pulmonary embolism, the acute respiratory distress syndrome, aspergillosis, sepsis and septic shock, bacterial meningitis, carbon monoxide poisoning, and methanol poisoning.
Search in this issue:
RSS Feeds