How should we play our hand when holding an ACE?

How vigorously should we exercise our rheumatoid arthritis patients?

How should we be selecting our graduate students?

We use many quantitative undergraduate metrics to help select our graduate students, but which of these usefully discriminate successful from underperforming students and which should be ignored? Almost everyone has his or her own pet theory of the most predictive criteria, but I hoped to address this question in a more unbiased manner. I conducted a retrospective analysis of the highest- and l...

Prosthetic valve thrombosis: when and how should we lyse?

Ö o ( c p e fi ( ( t d v ( l With the advent of the Starr-Edwards mechanical mitral and aortic valves in the 1960s, the surgical era of the treatment of cardiac valvular disease began in earnest. Although considered definitive, valve replacement surgery effectively represents an exchange of the pathophysiology of severe valvular dysfunction for the diseases and complications associated with pro...

When and how far should we lower blood pressure?

The accuracy of the diagnosis of mild or borderline hypertension is dubious. Perhaps up to one-third of such patients are wrongly categorized when more accurate measures are taken, largely because of the "defense" reaction. The recent trials of mild hypertension are discussed. Patients with a diastolic blood pressure in the range of 95 to 100 mm Hg should only begin treatment after careful asse...

Efaproxiral: should we hold our breath?

Suh et al breathe a bit of new life into two long-standing endeavors with their report in this issue of a phase III study of whole-brain radiotherapy (WBRT) and efaproxiral (RSR13), a hemoglobin modifier meant to increase tissue oxygenation. For decades, radiation oncologists have sought to enhance tumor control and patient survival by addressing the problem of hypoxia and, separately, to impro...