Internal Medicine Alert 2004-01-15

Another Myth Debunked

The fact that a study about mattresses and back pain was published in The Lancet is a testimony to the prevalence of back pain and the dearth of real science about how to deal with it.

Angiotensin II Antagonist as an Alternative to an ACE Inhibitor for Heart Failure after Myocardial Infarction

Previous research failed to show that the angiotensin II antagonist losartan at 50 mg per day was as effective as captopril in reducing mortality in patients with heart failure after myocardial infarction. This raised the question of whether this new class of drugs may be substituted for ACE inhibitors in treating these high-risk patients.

Is Everyone at Risk for Venous Thrombosis on Long-Distance Air Flights?

Two interesting articles published in the December 2003 issue of the Archives of Internal Medicine address the problems of isolated calf muscle venous thrombosis with and without complicating pulmonary emboli.

CT Virtual Colonoscopy for Colorectal Neoplasia

This multicenter study compared results of initial virtual colonoscopy with a 3-dimensional computerized tomographic approach with subsequent standard video colonoscopy.

Best Office Test for Quadriceps Weakness

Thirty-three consecutive patients with l3 or l4 radiculopathy were compared to 19 controls of comparable age to determine the best method for detecting quadriceps weakness in the office setting.

Pharmacology Update: Estradiol Topical Emulsion (Estrasorb)

A topical estradiol emulsion has been approved for treating symptoms of menopause. Currently available estrogen products include pills, patches, and vaginal rings. The new estrogen emulsion provides another option for estrogen therapy. Novavax Inc markets this topical formulation as Estrasorb.

Clinical Briefs

Combined Levothyroxine Plus Liothyronine Compared to Levothyroxine Alone in Primary Hypothyroidism; Specific Site Involvement in Fixed Drug Eruption; Anticoagulation Therapy for Stroke Prevention in Patients with Atrial Fibrillation

ECG Review: "Painful" Heart Block

The rhythm strip shown in the Figure was obtained from a middle-aged man in severe pain from a musculoskeletal disorder. He was not having chest pain, and had no known history of cardiovascular disease. He had an episode of vomiting shortly before this tracing was recorded. Is there evidence of heart block? If so, what type?

Pharmacology Watch: Vioxx Might Control Postoperative Knee Pain

Oral rofecoxib (Vioxx) may have a role in controlling postoperative pain patients undergoing knee surgery.

Internal Medicine Alert – January 15, 2004

January 15, 2004