The spectrum of vasculitis is diverse, and numerous entities do not fit the aforementioned broad categories. Examples of these include Buerger's disease; vaso-occlusive vasculitis of the lower extremities associated with cigarette smoking; Behçet's disease, which is prevalent in the Orient and Middle East and is characterized by recurrent aphthous stomatitis, genital ulcerations, uveitis, meningoencephalitis, and phlebitis; and isolated central nervous system vasculitis, a rare disease with a poor prognosis that primarily affects intracranial arteries without a systemic acute-phase response. Improvement in the classification and definitive therapy of vasculitis awaits identification of etiologic agents and definition of host factors and the immune response responsible for the pathology.

A comprehensive review of transdermal nicotine treatment for tobacco dependence, with recommendations derived from the research literature.

To review the studies on diagnostic evaluation of syncope and to provide an approach to the diagnostic testing and management of this condition.

Cardiac arrest treatment continues to evolve. Adequate treatment of the individual patient requires that the whole ECC system function smoothly, consistently, and rapidly. To maximize communitywide survival rates, a careful evaluation of the entire chain of survival is required using standard measurements of performance. The challenge for the next decade is to establish this infrastructure and to conduct multicenter, prospective, controlled clinical trials to better define the key factors that will improve survival of cardiac arrest in every community.

Radiofrequency catheter ablation has very quickly generated considerable enthusiasm among electrophysiologists because it offers a less invasive alternative to an open surgical procedure and potentially offers an alternative to lifelong drug therapy. Early literature on RF catheter ablation focused on the technical aspects of the procedure. In contrast, the literature of the past several years is dominated by very favorable reports of large series of patients and the experience of individual institutions. The larger series have focused on the treatment of accessory pathways as opposed to AV nodal reentry pathways. The opinions of the DATTA panelists parallel the literature. The panelists considered the technology to be established in terms of its safety and effectiveness as a curative treatment of accessory pathways, and promising in terms of its safety and between promising and established in terms of its effectiveness as a treatment of AV nodal reentrant tachycardias.

The Jones Criteria for guidance in the diagnosis of acute rheumatic fever were first published by T. Duckett Jones, MD, in 1944 and have been revised over the years by the American Heart Association. The current guidelines are an update of these criteria. For the first time, the guidelines are designed to establish the initial attack of acute rheumatic fever. Major manifestations, minor manifestations, and supporting evidence of antecedent group A streptococcal infection are discussed. These updated guidelines expand on the available tools to diagnose streptococcal pharyngitis and clarify the available antibody tests for detecting antecedent group A streptococcal infection. At the present time echocardiography without accompanying auscultatory findings is insufficient to be the sole criterion for valvulitis in acute rheumatic fever. Finally, this article addresses overdiagnosis of rheumatic fever and lists exceptions to the Jones Criteria, including recurrent attacks in individuals with a history of rheumatic fever.

One third of all deaths in women in the United States each year are attributable to coronary heart disease. Gender differences exist in the course and management of patients with coronary heart disease. Few randomized trials have been conducted in women to evaluate effective therapeutic strategies. With the aim of developing rational approaches to women with coronary heart disease, we review gender-related outcomes with coronary revascularization and reperfusion therapies.

To provide an overview of the postmenopausal estrogen/breast cancer controversy emphasizing the sources of disagreement in the literature and their clinical and research implications.