Table of Contents

April 17, 2001; 134 (8)

Articles

  • In patients who had preexisting vascular disease or diabetes combined with an additional cardiovascular risk factor, mild renal insufficiency significantly increased the risk for subsequent cardiovascular events. Ramipril reduced cardiovascular risk without increasing adverse effects.

  • Elderly patients had a higher rate of major perioperative complications and mortality after noncardiac surgery and a longer length of stay compared with younger patients. Even in patients 80 years of age or older, however, mortality was low.

  • Patients with paced rhythms were less likely than those without to receive treatment for acute myocardial infarction and had poorer short- and long-term outcomes. However, this mortality risk diminished after adjustment for treatment. This suggests that improved recognition and treatment of myocardial infarction may improve outcomes, particularly in the short term.

Brief Communications

  • This study confirms neocytolysis and the role of erythropoietin in persons with polycythemia who descend from high altitude. These findings may have implications that extend beyond space and altitude medicine to renal disease and other situations that involve erythropoietin suppression, hemolysis, and polycythemia.

Academia and Clinic

  • Investigators and editors developed the original CONSORT (ConsolidatedStandardsofReportingTrials) statement to help authors improve reporting of randomized, controlled trials by using a checklist and flow diagram. The revised CONSORT statement presented in this paper incorporates new evidence and addresses some criticisms of the original statement.

  • The CONSORT statement facilitates critical appraisal and interpretation of randomized, controlled trials by providing guidance to authors about how to improve the reporting of their trials. This explanatory and elaboration document is intended to enhance the use, understanding, and dissemination of the CONSORT statement.

Review

  • In the past 2 years, three new disease-modifying antirheumatic drugs (DMARDs) have been approved: leflunomide, etanercept, and infliximab. Studies examining these drugs and existing DMARDs (sulfasalazine and hydroxychloroquine) in combination with methotrexate clearly demonstrate that clinical responses can be meaningfully improved when new and existing DMARDs are added to methotrexate.

Editorials

  • In this issue, Mann and colleagues report that ramipril safely reduced risk for cardiovascular disease in patients with mild renal insufficiency and that mild renal insufficiency is an independent risk factor for cardiovascular disease. It may be more than coincidental that angiotensin-converting enzyme inhibitors seem both renoprotective and cardioprotective. Understanding the link between cardiovascular risk factors and kidney damage may be key to finding better ways to prevent and treat kidney and cardiovascular disease.

  • As shown by Rice and colleagues' study in this issue, the lessons learned from space medicine have already produced some important information about neocytolysis. A deeper understanding of this process may be particularly helpful in exploring the expanding universe of possibilities.

Letters

Medical Writings: Book and Software Notes

Current Clinical Issues

Book Listings

Medical Notices

Summaries for Patients