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The development of a highly effective, oral, 6-month regimen for the treatment of multidrug-resistant tuberculosis, which previously took 18 to 24 months to cure, is one of the defining achievements of the tuberculosis research community in this century. The results of the Nix-TB study, which were published in the

In contemporary clinical practice, interventional cardiologists use both fractional flow reserve (FFR) and intravascular ultrasonography (IVUS) to guide percutaneous coronary intervention (PCI) for intermediate coronary stenosis (i.e., a narrowing of the coronary-artery lumen by 40 to 70%). FFR, a physiological test, is used to evaluate the ischemic potential of a...

The landscape for stroke prevention in atrial fibrillation has been changed by the availability of the direct oral anticoagulants (DOACs) that have been tested in large, prospective, randomized trials for stroke prevention in patients with so-called nonvalvular atrial fibrillation. However, the definition of what is valvular or nonvalvular atrial fibrillation...

More than 100 years ago, Einthoven reported the presence of ST-segment changes on electrocardiography in a patient during exercise.¹ His discovery led to the development of the modern-day stress test. In patients with known coronary artery disease, the stress test is useful in assessing residual ischemia after an...

Hospitalization for heart failure, usually due to volume overload, is among the most common reasons for hospitalization worldwide, and decongestion with loop diuretics is the primary focus of treatment in most patients.¹ Despite the ubiquity of this clinical scenario in daily practice, high-quality data from randomized trials evaluating...

More than 6 million adults in the United States have heart failure, accounting for at least 800,000 hospitalizations annually.¹ More than half of these persons have heart failure with a preserved left ventricular ejection fraction.¹ As the population ages, the overall prevalence of patients with heart...

Ischemic cardiomyopathy represents the pathophysiological convergence of two growing clinical problems: atherosclerotic coronary artery disease and congestive heart failure. When a patient presents with congestive heart failure, it is incumbent on clinicians to undertake an etiologic workup that includes evaluation for a diagnosis of coronary artery disease¹ ; simply...

Next year marks the 20th anniversary of the first appearance of the polypill in the medical literature. Wald and Law coined the term to denote a fixed-dose combination of medications for preventing cardiovascular disease.¹ They suggested that administering a polypill to all adults 55 years of age or...

Genomes have different types of genetic variation, and many changes are assumed to be “silent” — that is, they have no effect on biology, health, or fitness. A recent study shows that it is not that simple.

Step therapy is a treatment approach often required by health insurers to control costs. It involves treating first with a lower-cost medication and, only if that proves ineffective, switching to another, more costly medication. Although step therapy is commonly applied in treating hypertension, diabetes, cancer, and other conditions, concerns regarding...

Acute hepatitis in children is certainly not new, and it can be worrisome. Successful worldwide vaccination campaigns over the past few decades have led to demonstrable improvements in public health and well-being by reducing the incidence and consequences of two viral causes — hepatitis A and B viruses. Many other...

In the first decade of this millennium, convincing data showing that screening for and treatment of gestational diabetes mellitus improve both maternal and fetal outcomes^1,2 ended debates within the obstetrical community about the usefulness of screening for gestational diabetes. Essentially all U.S. professional societies now recommend universal biochemical...

This interactive feature about screening for atrial fibrillation in asymptomatic older adults offers a case vignette accompanied by two essays, one supporting screening and the other supporting deferral of screening.