Update in General Internal Medicine

In 2005, several important studies challenged the general internist's definition of routine care for many conditions (Table). New data were published on the benefits of high-dosage statin therapy in patients with coronary disease and on the benefits and risks of β-blockers in the perioperative setting. New findings forced a reassessment of the effectiveness of vitamin E supplementation, cholinesterase inhibitor regimens in dementia, low-dosage aspirin therapy in women, sigmoidoscopy for colon cancer screening in women, alendronate therapy for osteopenia, and β-blockers as first-line therapy for uncomplicated hypertension. Other studies supported broader use of HIV screening and recommended ultrasonography to detect abdominal aortic aneurysms. Combination therapy with aspirin and a proton-pump inhibitor was also found to be the antiplatelet strategy of choice in patients who have a history of nonsteroidal anti-inflammatory drug–induced ulcers and who do not specifically require clopidogrel. Methicillin-resistant Staphylococcus aureus is becoming endemic in the community, but other news from the infectious disease arena was more encouraging: A vaccine to prevent shingles and postherpetic neuralgia will probably be available soon.