Drug eluting stents and late thrombosis

Unlike restenosis, which is fairly common, stent thrombosis is a rare but much more dangerous complication after coronary stent placement. It usually occurs before endothelialisation has been completed. For bare-metal stents, this process takes a few weeks; the newer, drug-eluting stents inhibit restenosis by inhibiting fibroblast proliferation, but they also tend to delay the endothelialisation […]

Another case-control study ?

This week’s JAMA has a cohort study from the Netherlands looking at the risk of community-acquired pneumonia and use of gastric acid–suppressive drugs. The authors used a large, private practice clinical database to investigate a hypothesized linkage between the prescription of proton pump inhibitors or H2 receptor blockers and community acquired pneumonia. In order to […]

Vestibular rehabilitation for dizziness

In the October 19 issue of Annals of Internal Medicine is a study from the UK of the effectiveness of primary care-based vestibular rehabilitation for chronic dizziness. Primary care patients with a history of labyrinthine dizziness that had lasted at least two months were randomized in a single blind fashion to receive nurse-taught vestibular rehabilitation […]

Review of antiplatelet therapy

In this week’s JAMA are several articles dealing with stroke, stroke prevention and antiplatelet therapy. Tran and Anand review oral antiplatelet therapy in cerebrovascular disease, coronary artery disease and peripheral arterial disease. They looked at trials involving antiplatelet therapy in patients with documented vascular disease (stroke, TIA, coronary disease, peripheral arterial disease). Some of the […]

Traffic as a trigger for MI

In today’s NEJM is an article from Augsburg, Germany looking at exposure to automobile traffic as a trigger for myocardial infarction. The statistical methods employed were almost completely incomprehensible to me � I would ask anyone who understands the “statistical analysis” paragraph to email me an explanation. But the bottom line is that, during the […]

Medical decision-making competence

This week’s Lancet contains a study by Raymont et al investigating the prevalence of mental incapacity in medical inpatients and associated risk factors (see also this item in Shrinkette’s blog ). In order to judge medical decision-making competence, the authors used two tools: the MacArthur competence assessment tool for treatment (MacCAT-T), and clinical vignettes (based […]

Endovascular repair of abdominal aortic aneurysms

An article in the October 14, 2004 New England Journal of Medicine reports on the results of the Dutch Randomized Endovascular Aneurysm Management (DREAM) trial, which compares endovascular abdominal aortic aneurysm repair with open surgical repair. 345 patients with AAA of at least 5 cm in diameter and who were eligible for both endovascular and […]