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The FDA has approved Atomoxetine (previously named tomoxetine), the first nonstimulant/noncontrolled drug to be approved for the treatment of attention-deficit/hyperactivity disorder (ADHD).
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The tracing in the Figure was obtained from a 59-year-old woman with a long history of smoking. She presented with acute dyspnea and atypical chest pain. Because of moderate respiratory difficulty, this was the best quality tracing obtainable. In full acknowledgment of its suboptimal technical quality, how would you interpret this ECG? What findings may be of potential concern?
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Within minutes of an acute cerebral ischemic insult, diffusion-weighted magnetic resonance imaging (DWI) demonstrates ischemic regions with a decline in the apparent diffusion coefficient (ADC) of water. ADC decline is associated with impaired high-energy metabolism and loss of ion homeostasis. Animal studies and preliminary observations in humans demonstrate that initial DWI and ADC abnormalities are reversible by early reperfusion.
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Among patients with coronary artery disease, HMG CoA reductase inhibitors (statins) are a mainstay of therapy. These drugs have also become widely prescribed with a low threshold to patients with elevated cholesterol and even minimal cardiac risk factors.
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Intravenous immunoglobulin (IVIG) is safe and effective therapy for acute exacerbations of myasthenia gravis (MG), myasthenic crisis, and for optimizing patients conditions in preparation for thymectomy. Its role in the long-term management of MG remains to be defined.
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Among patients undergoing epilepsy surgery for pharmacologically refractory seizures, detection and excision of a structural lesion congruent with the electroencephalographic ictal onset is a strong predictor of a seizure-free outcome.
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Overlap of symptomatology can make differentiation of myasthenia gravis (MG) from Lambert Eaton myasthenic syndrome (LEMS) challenging. Among 101 patients with MG and 38 with LEMS, clinical features allowing more accurate differential diagnosis are noted.
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In this randomized, double-blind trial, a total of 213 patients with relapsing-remitting or relapsing secondary progressive multiple sclerosis were assigned to 1 of 3 groups: natalizumab at 3 or 6 mg/kg (68 and 74 patients, respectively), or placebo (71 patients), by infusion every month for 6 months.
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The publication of the ALLHAT trial received much publicity not only in medical circles but was also front-page news in the Wall Street Journal. This trial was a significant blow to the pharmaceutical industry, and it convincingly showed that inexpensive diuretic medications had superiority over highly marketed ACE inhibitors and calcium channel blockers for the treatment of hypertension.
