Is albumin safe?

from prostate cancer is 3 percent and the lifetime risk of a diagnosis of prostate cancer is 16 percent, it is apparent that any approach that finds more cancers without quantifying the clinical significance of the detected disease will only increase overdiagnosis and overtreatment, as alluded to by Thompson et al. This, together with the absence of proof that PSA screening saves lives, should cause physicians to be circumspect about routinely recommending a pros-tate biopsy for men over the age of 50 years who have a PSA level of 4.0 ng per milliliter or less. Although the value of PSA screening remains controversial, men who present for periodic health examinations should be made aware of the availability of the PSA test, so that they can make an informed decision about the need for routine screening. The enthusiasm for screening in general in the United States suggests that most men will decide to be tested. 18 1. Tarone RE, Chu KC, Brawley OW. Implications of stage-specific survival rates in assessing recent declines in prostate cancer mortality rates. Epidemiology 2000;11:167-70. 2. Feuer EJ, Merrill RM, Hankey BF. Cancer surveillance series: interpreting trends in prostate cancer. II. Cause of death misclassifi-cation and the recent rise and fall in prostate cancer mortality. Prevalence of prostate cancer among men with a prostate-specific antigen level of ≤4.0 ng per milliliter. Chan DW, et al. Prostate specific antigen in the staging of localized prostate cancer: influence of tumor differentiation , tumor volume and benign hyperplasia.mended prostate-specific antigen testing intervals for the detection of curable prostate cancer. Influence of age and prostate-specific antigen on the chance of curable prostate cancer among men with nonpalpable disease. A prospective evaluation of plasma prostate-specific antigen for detection of prostatic cancer. Longitudinal evaluation of prostate-specific antigen levels in men with and without prostate disease. The Saline versus Albumin Fluid Evaluation (SAFE) Study, reported in this issue of the Journal, 1 heralds a new era in critical care marked by the large, simple, randomized trial popularized by cardiolo-gists. In a study of fluid resuscitation involving nearly 7000 critically ill patients, the Australian and New Zealand Intensive Care Society Clinical Trials Group addressed one of the most fundamental and contentious issues in critical care. Questions about the merits and demerits of colloids as opposed to crystalloids in the resuscitation of seriously ill patients have smoldered for decades, sparked by a meta-analysis suggesting that albumin …