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The articles featured in this issue are: 1) Supplemental Drug Application Submitted for Postoperative Nausea and Vomiting by John D. Zoidis, MD 2) Medicare Proposes Limits on Coverage for Erythropoiesis-Stimulating Drugs by John D. Zoidis, MD 3) Femara Reduces Risk of Early Breast Cancer Relapse in Postmenopausal Women by Prachi Patel-Predd 4) Researchers Develop Pancreatic Cancer Risk Model by Prachi Patel-Predd 5) Beyond BCG: New Bladder Cancer Treatments Offer Hope of Tailored, More Effective Therapies by Diane West 6) Doctor���¢�¯�¿�½�¯�¿�½s Own Brush With Bladder Cancer Gives Him Unique Insight to Patients���¢�¯�¿�½�¯�¿�½ Challenges by Diane West

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The presence of chronic kidney disease (CKD) in patients with atrial fibrillation increases the risk of stroke and thromboembolism (TE) as well as the risk of bleeding, thus complicating their treatment. In this context, it has been suggested that CKD should be included in the CHA2DS2-VASc (Congestive heart failure; Hypertension; Age ≥75 years; Diabetes mellitus; previous Stroke, transient ischemic attack, or thromboembolism; Vascular disease; Age 65 to 74 years; Sex category) score.

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The wireless, customizable NESS H200 Hand Rehabilitation System device has proven to give newfound independence to patients with paralyzed hands caused by a neurological disorder.

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Novel immunotherapy approaches to metastatic prostate cancer: Stimulating the immune response ex vivo with autologous antigen presenting cells.

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David Granet, MD and expert Jody Corey-Bloom, MD discuss multiple sclerosis and individuals with the diease share their stories.

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This 76-year-old woman presented to clinic with 8 weeks of severe scalp itching. She had previously been treated with emollient lotion, baby oil, a dandruff shampoo containing pyrithione zinc, and hydroxyzine. Her past medical history includes eczema, hypertension, hyperlipidemia, paroxysmal SVT, GERD, and depression. She is retired, volunteers at an elementary school, and does not drink alcohol, smoke tobacco, or use recreational drugs.

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We evaluated a multiethnic cohort of subjects with nonrheumatic atrial fibrillation hospitalized over a 6-year period to determine the racial and ethnic differences in the risk of intracranial hemorrhage (ICH) and the effect of warfarin treatment on ICH risk. Treatment with warfarin was associated with a 2-fold greater risk of ICH in whites, a 4- to 5-fold greater risk in both blacks and Hispanics, and a 15-fold greater risk in Asians. After adjusting for established stroke risk factors and warfarin use, Asians were 4 times as likely as whites to have ICH, whereas blacks and Hispanics were twice as likely.

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The benefits of implantable cardioverter-defibrillators (ICDs) have been shown in randomized clinical trials. The factors that affect the risk–benefit ratio in a community setting, however, have not been evaluated.

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Practicing cardiologists often joke about putting "statins" in the drinking water to stem the epidemic of atherosclerotic cardiovascular disease, but curiously, I don't believe that refers, even in jest, to a cocktail combination of drugs.

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Expert rheumatologists examine patterns of treatment failure in gout, in light of six recent guidelines on the condition. This brief slide show based on their review summarizes basics about the guidelines and the clues to optimal treatment, linking to the review itself.

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Methadone HCI (Diskets, Dolophine, Methadose) is a synthetic opioid that has been used widely in the United States for the management of heroin addiction Treatment of opioid dependence has been shifting gradually from the older US Food and Drug Administration (FDA) inspection program, ...

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The red eye is the most common ocular disorder seen by primary care physicians and ophthalmologists. Often benign and self-limiting, some diseases associated with a red eye can nevertheless threaten eyesight or even life. Disorders that cause rapid blindness include infectious corneal ulcers, angle-closure glaucoma, traumatic or postoperative endophthalmitis, hyperacute gonococcal conjunctivitis, chemical injuries, and ocular trauma. The many clinical images accompanying the conditions discussed will enhance recognition of the important symptoms and signs of each disease, enabling the primary care physician to appropriately manage the patient with a red eye and refer urgent cases to an ophthalmologist.

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Radiofrequency catheter ablation (RFA) is a cost-effective approach that has modified the treatment of patients with supraventricular tachycardia. In the Loire-Ardèche-Drôme-Isère-Puy-de-Dôme (LADIP) study, we compared RFA treatment with amiodarone therapy after the first episode of symptomatic atrial flutter. Results showed that RFA should be considered a first-line treatment, especially in elderly patients, because it has a better long-term success rate, the same risk of subsequent atrial fibrillation as amiodarone, and fewer secondary effects compared with amiodarone. Radiofrequency catheter ablation first-line therapy should be recommended in routine clinical practice, even when the atrial flutter is isolated without a previously documented atrial fibrillation episode.

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With the US Food and Drug Administration's recent approval of 2 sublingual immunotherapies for allergic rhinitis with or without conjunctivitis, US physicians no longer have to pursue the off-label use of these treatments.

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We conducted a prospective, double-blind, randomized, multicenter study among 241 patients who underwent their first on-pump coronary artery bypass graft (CABG) surgery, aortic valve replacement (AVR), or combined CABG and AVR surgery to determine whether the use of hydrocortisone prevents atrial fibrillation after cardiac surgery. Results showed that the incidence of postoperative atrial fibrillation was significantly lower in the hydrocortisone group compared with the placebo group.

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We examined data from a large cohort of subjects with atrial fibrillation to determine whether men and women had different risks for atrial fibrillation-related thromboembolism. Women with atrial fibrillation who were not taking warfarin had a 60% higher rate of stroke than did men, independent of other clinical risk factors for stroke. When taking warfarin, both women and men had significant reductions in stroke risk without differences by sex in the rates of bleeding complications. These findings support the addition of female sex to traditional stroke risk stratification schemes for assisting in antithrombotic decision making for patients with atrial fibrillation.

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For the nearly 24 million Americans with diabetes, a pharmacist-led disease state management program is making a difference.

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This propensity-matched study, in which patients with and without diabetes were well balanced in all measured baseline characteristics, including traditional risk factors and comorbidities, found that diabetes was associated with increased mortality and hospitalization in ambulatory patients who had chronic, mild-to-moderate heart failure and were receiving angiotensin-converting enzyme inhibitors. These findings also highlight the sex- and age-related variations in the effect of diabetes in these patients.