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In 1998, Beyth and colleagues developed a modified outpatient bleeding risk index. In this prospective study conducted at the University of Ottawa, 222 patients with diagnosed pulmonary embolism or deep venous thrombosis were observed for an average of 18.5 months.
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Elevated homocysteine levels have been associated with atherosclerosis. Folic acid supplementation is a simple, inexpensive way to reduce homocysteine levels, which has become popular for secondary prevention in patients with coronary artery disease (CAD), despite a paucity of long-term clinical trial data. Thus, Liem and colleagues studied 593 patients with stable CAD on statins who were randomized to open-label folic acid 0.5 mg/d or standard care, which included aggressive pursuit of lipid goals.
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The ECG in the Figure was obtained from a 78-year-old man with long-standing pulmonary disease and new-onset heart failure. Based on the low voltage in leads V1, V2, V3, the rightward frontal plane axis, incomplete right bundle-branch block, and persistent precordial S waves, the computer interpreted the overall pattern as consistent with pulmonary disease. What else should be added to your interpretation?
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The diagnosis of patients with chest pain is straightforward only occasionally. A systematic method of evaluating these patients is essential to assess for potentially life-threatening conditions. This article discusses noncardiac causes of chest pain, particularly GI causes and aortic dissection.
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The Women's Health Initiative (WHI) was halted 1 year ago, but fallout
from this landmark study continues. The study was designed to identify
the risks or benefits of estrogen plus progesterone vs placebo in
healthy postmenopausal women.
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The FDA has approved the first nasally administered flu vaccine. This cold-adapted, temperature sensitive, attenuated, trivalent vaccine is manufactured by MedImmune Vaccine, Inc. and marketed by MedImmune and Wyeth under the name FluMist. The nasal flu vaccine should be available this fall.
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While the numbers of cases of West Nile virus infection in the United States were relatively small from 1999 through 2001, in 2002 an epidemiologic explosion occurred with 4156 cases, including 284 deaths, in 44 states plus the District of Columbia.
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Taking into consideration the limitations of this study, it is time to for sliding-scale insulin to join bloodletting and trepanation in the Museum of Medical Anachronisms.