Atrial fibrillation (AF) is the most common arrhythmia in the world. Risk factor modification, anticoagulation, rhythm control, and rate control are the four pillars of its management. American College of Cardiology/American Heart Association (ACC/AHA) guidelines on management of AF were updated recently.

Topical tretinoin (all-trans-retinoic acid) has been used for years to treat skin damaged by chronic exposure to the sun (Medical Letter, 34:28, 1992). First approved by the FDA only for treatment of acne in concentrations ranging from 0.025% to 0.1% (Retin-A, and others), it has now been approved as an 0.05% formulation in an emollient cream base (Renova) for topical treatment of photodamaged skin. In recent years, alpha-hydroxy acids incorporated in some cosmetics have also been promoted as effective in improving the appearance of aging skin.

Nearly 30 years after the first publication of Dr. Atkins' Diet Revolution promoting a high-protein, extremely low-carbohydrate diet, patients once again are asking their physicians about the Atkins diet.

Amprenavir is the fifth protease inhibitor to become available for treatment of HIV infection. It was approved by the FDA for use with other drugs in the treatment of HIV-infected adults and children at least four years old.

The FDA has approved apixaban (Eliquis – Bristol-Myers Squibb/Pfizer), an oral direct factor Xa inhibitor, for prevention of stroke and systemic embolism in patients with nonvalvular atrial fibrillation. It is the third new oral anticoagulant to be approved for this indication as an alternative to warfarin.

Alzheimer's disease (AD) is the most common cause of dementia, but cognitive decline is also associated with other neurological conditions such as Parkinson's disease, dementia with Lewy bodies, vascular dementia, and frontotemporal dementia.

Sitagliptin (Januvia) and metformin (Glucophage, and others) are now available in a single tablet (Janumet - Merck) for treatment of type 2 diabetes. The combination is approved by the FDA for use in patients not adequately controlled by sitagliptin or meformin alone or in those already taking both drugs. Metformin is also available in combination with the thiazolidinediones pioglitazone and rosiglitazone and with the sulfonylureas glipizide and glyburide.

The FDA has approved rivaroxaban (Xarelto – Janssen), an oral direct factor Xa inhibitor, for prevention of deep vein thrombosis (DVT) in patients undergoing knee or hip replacement surgery.

View the Comparison Table: Some Oral Anticoagulants for VTE

Results of a recent study suggested that zinc gluconate may be effective in treating the common cold (SB Mossad et al, Ann Intern Med, 125:81, July 15, 1996). Zinc gluconate lozenges, sometimes combined with vitamin C or other ingredients, are available in pharmacies and health food stores throughout the USA.