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=====================MEDSCAPE's
MedPulse(R)===================
What's new on
Medscape, the world's leading medical Web site.
READ THE FULL-TEXT
ARTICLES ON THE WORLD WIDE WEB at:
http://www.medscape.com/
Links to articles
featured below may be found at:
http://www.medscape.com/Medscape/public/MP/99/0108.html
==========================
~~~~~~~~~~~~ This
week's MedPulse is sponsored by ~~~~~~~~~~~
M e d s c a p e B o
o k s t o r e
The Largest Online
Medical Bookstore
Now offering 10%
off all purchases!!
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
________
CONTENTS
o New Feature
Articles This Week
o Exam Room
o Announcements
- GET YOUR OWN FREE
MEDSCAPE MAIL ACCOUNT!
o User Support
______________________________
NEW FEATURE
ARTICLES THIS WEEK
o Cardiology__________________________________________________
<http://www.medscape.com/Medscape/public/MP/99/0108.html#02>
- Glucose
Intolerance, Physical Signs of Peripheral Artery
Disease, and Risk
of Cardiovascular Events
----------------------------------------------------------
Physical findings
of PAD may signify a compromised arterial
circulation to the
heart and brain as well as the limbs in
patients with
glucose intolerance, and may be a risk factor
for coronary
disease, heart failure, and stroke.
[Am Heart J
136(5):919-927, 1999]
PLUS...
- Atherogenic,
Hemostatic, and Other Potential Risk Markers
in Subjects With
Previous Isolated Myocardial Infarction
Compared With
Long-standing Uncomplicated Stable Angina
o HIV/AIDS_____________________________________________________
<http://www.medscape.com/Medscape/public/MP/99/0108.html#01>
- Antiretroviral
Agents and Food Interactions
----------------------------------------------------------
With the increasing
complexity of antiretroviral therapy
regimens, the
possibility for significant drug-food interactions
increases, and the
clinician must be able to prevent, detect, and
deal with these
interactions.
[Infect Med
15(12):836-839, 873, 1999]
PLUS...
- Guest Editorial -
AIDS: A Disease of the Young?
o Infectious
Diseases_________________________________________
<http://www.medscape.com/Medscape/public/MP/99/0108.html#03>
- Rubella Serology
in Mentally Retarded Adults
----------------------------------------------------------
Although the risk
of congenital rubella syndrome was low
because of the
small number of fertile women in this population
of
institutionalized adults, more than one-fourth of the
fertile women were
found to lack demonstrable serologic
confirmation of
rubella immunity.
[South Med J
91(9):842-846, 1999]
o Internal Medicine___________________________________________
<http://www.medscape.com/Medscape/public/MP/99/0108.html#04>
- Leg Weakness in
Neurosarcoidosis
----------------------------------------------------------
A 22-year-old male
presented with leg weakness and decreased
hearing. After
neuroimaging studies and lymph node biopsy,
he was diagnosed
with neurosarcoidosis. This disease entity
should be suspected
in young patients with diffuse
lymphadenopathy,
cauda equina lesions, and paranasal
opacification.
[South Med J
91(9):870-872, 1999]
PLUS...
- A Pitfall in the
Diagnosis of Left Main Coronary
Obstruction Due to
Aortic Dissection
- Admission Serum
Albumin Level and Length of Hospitalization
in Elderly Patients
o Managed Care________________________________________________
<http://www.medscape.com/Medscape/public/MP/99/0108.html#05>
- Managed Care
Matters - Introducing the Automated Pharmaceutical
Account Rep
----------------------------------------------------------
"What really
irks managed care pharmacy directors are account
reps who really
have no idea of the specifics of the plan
they are trying to
contract with. They may know it's an HMO --
and that's about
it."
[Drug Benefit
Trends 10(12):22, 1999]
PLUS...
- Viewpoint - The
Strategic Importance of Pharmacogenomics
in the Future of
the Pharmaceutical Industry
o Medical Practice____________________________________________
<http://www.medscape.com/Medscape/public/MP/99/0108.html#06>
- Legal Brief -
Signing Away Your Future
----------------------------------------------------------
Given the way
consolidation and competition are sweeping
through medicine,
more and more doctors will be asked to
sign noncompete or
other restrictive covenants limiting
their ability to
practice once they've left a job or
partnership.
[Hippocrates
12(12):25-26, 1999]
PLUS...
- Medicine &
the Law - Challenging Blue's Medical Necessity
Denials
o Oncology____________________________________________________
<http://www.medscape.com/Medscape/public/MP/99/0108.html#08>
- A Breast Cancer
Patient With Disseminated Scedosporium
prolificans
Infection
----------------------------------------------------------
Clinicians must
maintain a strong clinical suspicion for
Scedosporium
infection in cancer patients treated for
Aspergillus who do
not improve on standard amphotericin B.
[Infect Med
15(12):849-852, 855, 1999]
o Orthopedics_________________________________________________
<http://www.medscape.com/Medscape/public/MP/99/0108.html#09
- Late
Reconstruction of Flexor and Extensor Tendon Injuries
----------------------------------------------------------
Late reconstructive
techniques are needed to repair flexor
and extensor tendon
injuries if repair is done more than
3 weeks after
trauma.
[Medscape
Orthopedics & Sports Medicine 3(1), 1999]
PLUS...
- Clinical
Abstracts - Flexor and Extensor Tendon Injuries
of the Hand
o
Pediatrics__________________________________________________
<http://www.medscape.com/Medscape/public/MP/99/0108.html#10>
- Imaging
Gastrointestinal Abnormalities in Children With AIDS
----------------------------------------------------------
GI manifestations
of AIDS in children include opportunistic
infections and
malignant neoplasms; the appropriate radiographic
test will
facilitate an accurate and timely diagnosis.
[The AIDS Reader
8(4):187-191, 1999]
PLUS...
- Rotavirus
o Pharmacotherapy_____________________________________________
<http://www.medscape.com/Medscape/public/MP/99/0108.html#11>
- Persistent High
Restenosis After Local Intrawall Delivery of
Long-Acting
Steroids Before Coronary Stent Implantation
----------------------------------------------------------
Local drug delivery
of long-acting steroids before coronary
stenting did not
reduce the angiographic restenosis rate and
the incidence of
target lesion revascularization, arguing
against the use of
steroids during stent implementation.
[J Invas Cardiol
10(6):323-331, 1999]
PLUS...
- Drug-Induced
Changes in Eustachian Tube Function
o Primary Care________________________________________________
<http://www.medscape.com/Medscape/public/MP/99/0108.html#12>
- Impaired
Endothelium-Dependent Vasodilatation in Women With
Previous
Gestational Diabetes
----------------------------------------------------------
Compared to women
known to have been normoglycemic during
pregnancy, women
with a history of gestational diabetes
exhibited impaired
flow-mediated dilatation (FMD) in the
brachial artery, a
response that depends on intact endothelial
function and in
which the vasodilator nitric oxide (NO) is
generated in
response to increased sheer stress on the vessel
wall.
[Diabetes Care
21(12):2111-2115, 1999]
PLUS...
- Image of the Week
- DermaDiagnosis
o Respiratory Care____________________________________________
<http://www.medscape.com/Medscape/public/MP/99/0108.html#14>
- Acute
Exacerbations of COPD Require Aggressive Treatment
----------------------------------------------------------
Increased cough, purulent
sputum, wheezing, dyspnea, and
occasionally fever
are indicative of an acute exacerbation
of COPD. Management
must be aggressive and include oxygen
therapy, inhaled
bronchodilators, corticosteroids, and
antibacterials.
[Drugs & Ther
Perspect 12(11):8-9, 1999]
PLUS...
- Efficacy and
Tolerability Comparison of Ebastine 10 and
20mg With
Loratadine 10mg
o
Surgery_____________________________________________________
<http://www.medscape.com/Medscape/public/MP/99/0108.html#15>
- Is Bigger Always
Better in Arterial Intervention?
----------------------------------------------------------
After stent
deployment, an intravascular ultrasound cross-
sectional lumen
area greater than 9mm2 has been
associated with
restenosis rates in the single-digit range,
making acceptance
of the "bigger is better" concept uniform.
This concept
predicts excellent results in these vessels and
even better
restenosis rates in larger vessels such as the
iliac and carotid
arteries.
[J Invas Cardiol
10(8):521-527, 1999]
PLUS...
- Persistent High
Restenosis After Local Intrawall Delivery
of Long-Acting
Steroids Before Coronary Stent Implantation
o
Women's Health______________________________________________
<http://www.medscape.com/Medscape/public/MP/99/0108.html#17>
- Virtual Consult-
Pregnant Woman With Sickle-Cell Disease
----------------------------------------------------------
How would you
manage this lifelong sickle-cell sufferer who
presents in active
labor and sickle-cell crisis? Medscape
Women's Health
Co-editor-in-Chief, Joseph Pastorek, MD,
FACOG, moderates
the case discussion.
[Medscape Women's
Health 3(6), 1999]
PLUS...
- Book Review -
Women and Heart Disease
==========================
_________
EXAM ROOM
Check into
Medscape's "Exam Room" and test yourself with
dozens of
challenging self-assessment features, including
Today's Question
and PicTours[R] (click on an image, and
make a diagnosis
today).
o Today's Question
-- Questions posted this week
-------------------------------------------------------------
Test
your clinical knowledge with the questions posted this
week.
<http://www.medscape.com/Medscape/public/MP/99/0108.html#18>
? What do CME
resources on the Internet offer the practicing
physician?
? True or False:
Colorectal cancer is the second leading cause
of cancer-related
deaths in the US.
? A 10-year-old,
otherwise healthy boy presents with a right
forearm fracture.
What is the most appropriate treatment
for this injury?
? Which groups in
the following list do not need adult
vaccinations?
Immunocompromised persons, alcoholics,
drug abusers,
international travelers, nursing home residents,
immigrants,
prisoners, homeless persons, school employees.
? Which new
anti-HIV drug was recently endorsed by DHHS
guidelines as a
component of initial therapy regimens?
_____________
ANNOUNCEMENTS
o -----------GET YOUR
OWN FREE MEDSCAPE MAIL ACCOUNT!-----------
With a FREE
Medscape Mail account you can:
* Send and receive
email from the Web -- anywhere, anytime
* Automatically
forward email from your other email accounts
to your Medscape
Mail address
* Block spam and
unwanted mail, and more
Don't let multiple
office/hospital locations, travel, or a
change in your
Internet Service Provider keep you from getting
your email. Go to
http://www.medscape.com and sign in. Then,
click on Medscape
Mail to enroll today for your FREE permanent
and private
Medscape email address that goes with you wherever
you go!
____________
USER SUPPORT
o For answers to
frequently asked questions or technical support
(including how to
UNSUBSCRIBE), go to:
<http://www.medscape.com/Home/Help/Tech/FS-Tech.html>
==========================
~~~~~~~~~~~~ This
week's MedPulse is sponsored by ~~~~~~~~~~~
M e d s c a p e B o
o k s t o r e
The Largest Online
Medical Bookstore
http://www.lb.com/medscape/
Now offering 10%
off all purchases!!
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
From -
Tue Jan 19 17:51:39 1999
Return-Path:
<null@xu1.medscape.com>
Received: from
xu1.medscape.com (xu1.medscape.com [192.246.193.12])
by mercurio.interbook.net
(8.8.8/8.8.8) with SMTP id MAA18616
for
<jarilla@interbook.net>; Sun, 10 Jan 1999 12:42:15 GMT
Received: from
[192.246.193.5] by xu1.medscape.com (NTList 3.02.13) id va126485; Fri, 8 Jan
1999 17:18:16 -0500
Received: from
xu1.medscape.com (151.198.116.147) by mail.medscape.com with
ESMTP (Eudora
Internet Mail Server 2.2); Fri, 8 Jan 1999 16:45:46 -0500
Message-ID:
<36967CCD.543BE23C@xu1.medscape.com>
Date: Fri, 08 Jan
1999 16:46:53 -0500
From:
"Medscape's Medpulse" <news@xu1.medscape.com>
Organization:
Medscape
X-Mailer: Mozilla
4.5 [en] (Win95; I)
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en
MIME-Version: 1.0
Subject: Medscape's
MedPulse 1/8/99 - GET YOUR OWN FREE MEDSCAPE MAIL ACCOUNT!
Content-Type:
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Content-Transfer-Encoding:
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To:
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a5cc3763c4fa110e867d963d2396e950
X-Mozilla-Status:
8001
=====================MEDSCAPE's
MedPulse(R)===================
What's new on
Medscape, the world's leading medical Web site.
READ THE FULL-TEXT
ARTICLES ON THE WORLD WIDE WEB at:
http://www.medscape.com/
Links to articles
featured below may be found at:
http://www.medscape.com/Medscape/public/MP/99/0108.html
==========================
~~~~~~~~~~~~ This
week's MedPulse is sponsored by ~~~~~~~~~~~
M e d s c a p e B o
o k s t o r e
The Largest Online
Medical Bookstore
http://www.lb.com/medscape/
Now offering 10%
off all purchases!!
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
________
CONTENTS
o New Feature
Articles This Week
o Exam Room
o Announcements
- GET YOUR OWN FREE
MEDSCAPE MAIL ACCOUNT!
o User Support
______________________________
NEW FEATURE
ARTICLES THIS WEEK
o
Cardiology__________________________________________________
<http://www.medscape.com/Medscape/public/MP/99/0108.html#02>
- Glucose
Intolerance, Physical Signs of Peripheral Artery
Disease, and Risk
of Cardiovascular Events
----------------------------------------------------------
Physical findings
of PAD may signify a compromised arterial
circulation to the
heart and brain as well as the limbs in
patients with
glucose intolerance, and may be a risk factor
for coronary
disease, heart failure, and stroke.
[Am Heart J
136(5):919-927, 1999]
PLUS...
- Atherogenic,
Hemostatic, and Other Potential Risk Markers
in Subjects With
Previous Isolated Myocardial Infarction
Compared With
Long-standing Uncomplicated Stable Angina
o
HIV/AIDS_____________________________________________________
<http://www.medscape.com/Medscape/public/MP/99/0108.html#01>
- Antiretroviral
Agents and Food Interactions
----------------------------------------------------------
With the increasing
complexity of antiretroviral therapy
regimens, the
possibility for significant drug-food interactions
increases, and the
clinician must be able to prevent, detect, and
deal with these
interactions.
[Infect Med
15(12):836-839, 873, 1999]
PLUS...
- Guest Editorial -
AIDS: A Disease of the Young?
o Infectious
Diseases_________________________________________
<http://www.medscape.com/Medscape/public/MP/99/0108.html#03>
- Rubella Serology
in Mentally Retarded Adults
----------------------------------------------------------
Although the risk
of congenital rubella syndrome was low
because of the
small number of fertile women in this population
of
institutionalized adults, more than one-fourth of the
fertile women were
found to lack demonstrable serologic
confirmation of
rubella immunity.
[South Med J
91(9):842-846, 1999]
o Internal Medicine___________________________________________
<http://www.medscape.com/Medscape/public/MP/99/0108.html#04>
- Leg Weakness in
Neurosarcoidosis
----------------------------------------------------------
A 22-year-old male
presented with leg weakness and decreased
hearing. After
neuroimaging studies and lymph node biopsy,
he was diagnosed
with neurosarcoidosis. This disease entity
should be suspected
in young patients with diffuse
lymphadenopathy,
cauda equina lesions, and paranasal
opacification.
[South Med J
91(9):870-872, 1999]
PLUS...
- A Pitfall in the
Diagnosis of Left Main Coronary
Obstruction Due to
Aortic Dissection
- Admission Serum
Albumin Level and Length of Hospitalization
in Elderly Patients
o Managed
Care________________________________________________
<http://www.medscape.com/Medscape/public/MP/99/0108.html#05>
- Managed Care
Matters - Introducing the Automated Pharmaceutical
Account Rep
----------------------------------------------------------
"What really
irks managed care pharmacy directors are account
reps who really
have no idea of the specifics of the plan
they are trying to
contract with. They may know it's an HMO --
and that's about
it."
[Drug Benefit
Trends 10(12):22, 1999]
PLUS...
- Viewpoint - The
Strategic Importance of Pharmacogenomics
in the Future of
the Pharmaceutical Industry
o Medical
Practice____________________________________________
<http://www.medscape.com/Medscape/public/MP/99/0108.html#06>
- Legal Brief -
Signing Away Your Future
----------------------------------------------------------
Given the way
consolidation and competition are sweeping
through medicine,
more and more doctors will be asked to
sign noncompete or
other restrictive covenants limiting
their ability to
practice once they've left a job or
partnership.
[Hippocrates
12(12):25-26, 1999]
PLUS...
- Medicine &
the Law - Challenging Blue's Medical Necessity
Denials
o
Oncology____________________________________________________
<http://www.medscape.com/Medscape/public/MP/99/0108.html#08>
- A Breast Cancer
Patient With Disseminated Scedosporium
prolificans
Infection
----------------------------------------------------------
Clinicians must
maintain a strong clinical suspicion for
Scedosporium
infection in cancer patients treated for
Aspergillus who do
not improve on standard amphotericin B.
[Infect Med
15(12):849-852, 855, 1999]
o
Orthopedics_________________________________________________
<http://www.medscape.com/Medscape/public/MP/99/0108.html#09
- Late
Reconstruction of Flexor and Extensor Tendon Injuries
----------------------------------------------------------
Late reconstructive
techniques are needed to repair flexor
and extensor tendon
injuries if repair is done more than
3 weeks after
trauma.
[Medscape
Orthopedics & Sports Medicine 3(1), 1999]
PLUS...
- Clinical
Abstracts - Flexor and Extensor Tendon Injuries
of the Hand
o
Pediatrics__________________________________________________
<http://www.medscape.com/Medscape/public/MP/99/0108.html#10>
- Imaging
Gastrointestinal Abnormalities in Children With AIDS
----------------------------------------------------------
GI manifestations
of AIDS in children include opportunistic
infections and
malignant neoplasms; the appropriate radiographic
test will
facilitate an accurate and timely diagnosis.
[The AIDS Reader
8(4):187-191, 1999]
PLUS...
- Rotavirus
o
Pharmacotherapy_____________________________________________
<http://www.medscape.com/Medscape/public/MP/99/0108.html#11>
- Persistent High
Restenosis After Local Intrawall Delivery of
Long-Acting Steroids
Before Coronary Stent Implantation
----------------------------------------------------------
Local drug delivery
of long-acting steroids before coronary
stenting did not
reduce the angiographic restenosis rate and
the incidence of
target lesion revascularization, arguing
against the use of
steroids during stent implementation.
[J Invas Cardiol
10(6):323-331, 1999]
PLUS...
- Drug-Induced
Changes in Eustachian Tube Function
o Primary
Care________________________________________________
<http://www.medscape.com/Medscape/public/MP/99/0108.html#12>
- Impaired
Endothelium-Dependent Vasodilatation in Women With
Previous
Gestational Diabetes
----------------------------------------------------------
Compared to women
known to have been normoglycemic during
pregnancy, women
with a history of gestational diabetes
exhibited impaired
flow-mediated dilatation (FMD) in the
brachial artery, a
response that depends on intact endothelial
function and in
which the vasodilator nitric oxide (NO) is
generated in response
to increased sheer stress on the vessel
wall.
[Diabetes Care
21(12):2111-2115, 1999]
PLUS...
- Image of the Week
- DermaDiagnosis
o Respiratory
Care____________________________________________
<http://www.medscape.com/Medscape/public/MP/99/0108.html#14>
- Acute
Exacerbations of COPD Require Aggressive Treatment
----------------------------------------------------------
Increased cough,
purulent sputum, wheezing, dyspnea, and
occasionally fever
are indicative of an acute exacerbation
of COPD. Management
must be aggressive and include oxygen
therapy, inhaled
bronchodilators, corticosteroids, and
antibacterials.
[Drugs & Ther
Perspect 12(11):8-9, 1999]
PLUS...
- Efficacy and
Tolerability Comparison of Ebastine 10 and
20mg With
Loratadine 10mg
o Surgery_____________________________________________________
<http://www.medscape.com/Medscape/public/MP/99/0108.html#15>
- Is Bigger Always
Better in Arterial Intervention?
----------------------------------------------------------
After stent
deployment, an intravascular ultrasound cross-
sectional lumen
area greater than 9mm2 has been
associated with
restenosis rates in the single-digit range,
making acceptance
of the "bigger is better" concept uniform.
This concept
predicts excellent results in these vessels and
even better
restenosis rates in larger vessels such as the
iliac and carotid
arteries.
[J Invas Cardiol
10(8):521-527, 1999]
PLUS...
- Persistent High
Restenosis After Local Intrawall Delivery
of Long-Acting
Steroids Before Coronary Stent Implantation
o Women's
Health______________________________________________
<http://www.medscape.com/Medscape/public/MP/99/0108.html#17>
- Virtual Consult-
Pregnant Woman With Sickle-Cell Disease
----------------------------------------------------------
How would you manage
this lifelong sickle-cell sufferer who
presents in active
labor and sickle-cell crisis? Medscape
Women's Health
Co-editor-in-Chief, Joseph Pastorek, MD,
FACOG, moderates
the case discussion.
[Medscape Women's
Health 3(6), 1999]
PLUS...
- Book Review -
Women and Heart Disease
==========================
_________
EXAM ROOM
Check into
Medscape's "Exam Room" and test yourself with
dozens of
challenging self-assessment features, including
Today's Question
and PicTours[R] (click on an image, and
make a diagnosis
today).
o Today's Question
-- Questions posted this week
-------------------------------------------------------------
Test your clinical
knowledge with the questions posted this
week.
<http://www.medscape.com/Medscape/public/MP/99/0108.html#18>
? What do CME
resources on the Internet offer the practicing
physician?
? True or False:
Colorectal cancer is the second leading cause
of cancer-related
deaths in the US.
? A 10-year-old,
otherwise healthy boy presents with a right
forearm fracture. What
is the most appropriate treatment
for this injury?
? Which groups in
the following list do not need adult
vaccinations?
Immunocompromised persons, alcoholics,
drug abusers,
international travelers, nursing home residents,
immigrants,
prisoners, homeless persons, school employees.
? Which new
anti-HIV drug was recently endorsed by DHHS
guidelines as a
component of initial therapy regimens?
_____________
ANNOUNCEMENTS
o -----------GET
YOUR OWN FREE MEDSCAPE MAIL ACCOUNT!-----------
With a FREE
Medscape Mail account you can:
* Send and receive
email from the Web -- anywhere, anytime
* Automatically
forward email from your other email accounts
to your Medscape
Mail address
* Block spam and
unwanted mail, and more
Don't let multiple
office/hospital locations, travel, or a
change in your
Internet Service Provider keep you from getting
your email. Go to
http://www.medscape.com and sign in. Then,
click on Medscape
Mail to enroll today for your FREE permanent
and private
Medscape email address that goes with you wherever
you go!
____________
USER SUPPORT
o For answers to
frequently asked questions or technical support
(including how to
UNSUBSCRIBE), go to:
<http://www.medscape.com/Home/Help/Tech/FS-Tech.html>
==========================
~~~~~~~~~~~~ This week's
MedPulse is sponsored by ~~~~~~~~~~~
M e d s c a p e B o
o k s t o r e
The Largest Online
Medical Bookstore
http://www.lb.com/medscape/
Now offering 10%
off all purchases!!
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~