Since publication of our recent article on antiviral drugs for influenza, increased levels of resistance to oseltamivir (Tamiflu) have been detected in influenza A H1N1 strains.

Implantable cardioverter defibrillators (ICDs) are widely used in patients at risk for sudden cardiac death (SCD) because these devices have been highly successful in terminating life-threatening ventricular arrhythmias and in increasing survival.

Tetrabenazine (Xenazine - Ovation Pharmaceuticals), an old drug first synthesized 50 years ago for treatment of schizophrenia, was recently approved by the FDA for the treatment of chorea associated with Huntington's disease. It has been available in other countries for decades.

The Medical Letter was founded in 1959 by Arthur Kallet, an engineer, and Dr. Harold Aaron, an internist. In 1932, Kallet had written the book 100,000,000 Guinea Pigs, a best-seller that was partly responsible for the Food and Drug Act of 1938, which required for the first time that new drugs show proof of safety. He was the founding director of Consumers Union and started the publication of Consumer Reports. Dr. Aaron, who became the medical director of Consumer Reports, suggested to Kallet that doctors could use a similar publication to evaluate the new drugs that were coming on the market with no counterweight to the manufacturers' claims. They borrowed $18,000 and started The Medical Letter. Apparently Dr. Aaron was correct in his perception; within 25 years, the new publication had 150,000 subscribers in the US and Canada.

After half a century, The Medical Letter is still supported solely by subscription fees and sales of its other products, which now include foreign editions (in Italian, French, Spanish and Japanese), a second newsletter (Treatment Guidelines), a drug interactions database, handbooks, software, licenses and continuing education materials. We still do not accept grants, gifts or donations. And we continue to refuse opportunities to sell large numbers of reprints to pharmaceutical companies.

Our mission remains to help practitioners offer the best possible care to their patients. For at least another 50 years.