Internal Medicine Alert – August 15, 2003
August 15, 2003
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Prostate-Specific Antigen: To Test and Test and Test Again? Or Should We Test at All?
Serum prostate-specific antigen (PSA) testing is frequently used in early detection programs for prostate cancer. While PSA testing has resulted in an increase in prostate cancer detection, its routine use has been questioned because of a lack of specificity. The objective of this study was to determine whether year-to-year fluctuations in prostate-specific antigen levels are due to natural variation and render a single PSA test result unreliable. -
Should Both Aspirin and Clopidogrel Be Used for the Treatment of Acute Coronary Syndromes?
Jneid and associates critically analyzed the results of the Clopidogrel in Unstable Angina to Prevent Recurrent Events (CURE) study and several other antiplatelet trials to provide guidance to the physician regarding the use of aspirin and/or clopidogrel in patients with ACS. -
More Bad News for Folic Acid
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. -
The Outpatient Bleeding Risk Index
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. -
Pharmacology Update: Omalizumab Injection (Xolair)
The FDA has approved Genentechs omalizumab, the first biotechnology drug for the treatment of asthma. -
Clinical Briefs
Metformin and Thiazolidinedione Use in Medicare Patients with Heart Failure; Alcohol Consumption Patterns and Biologic Markers of Glycemic Control Among 459 Women; Azelaic Acid Gel as a New Treatment for Papulopustular Rosacea -
ECG Review: A 3-Beat Run in Lead V1
The ECG in the Figure was obtained from a 57-year-old woman with palpitations. Is there a short run of VT (ventricular tachycardia) in lead V1? What else may be wrong with the tracing?