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Exercise capacity on treadmill predicts future cardiac eventsReduced exercise capacity is associated with an increased risk of myocardial infarction, unstable angina, and coronary revascularization in patients referred for exercise treadmill testing for clinical indications.
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The Emperor of All Maladies: Documenting Cancer's Long ReignAn interview with Siddhartha Mukherjee, author of the book "The Emperor of All Maladies: A Biography of Cancer."
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How Should I Approach This Woman with Migraine Headaches?Although many migraine sufferers can abort their headaches with over-the-counter remedies, a significant percentage of patients require prescription medication for relief.
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Anisakis spp. in humansAs exotic international locales become more accessible and American palates acquire a taste for more unusual fare, physicians may find themselves treating patients infected with organisms that are rarely seen in the United States, such as Anisakis spp.
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Transcatheter occlusion of the left atrial appendageAtrial fibrillation commonly affects millions of patients, and often causes the disabling complication of cardioembolic stroke.
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Hospitalists Who Love to Teach: Are There Enough to Go Around?The big question for academic hospital medicine is: with the cadre of hospitalists ballooning to 20,200 in 2007 and projected by the Society of Hospital Medicine (SHM) to hit 30,000 by 2010, are there enough teachers to go around?
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Transcatheter occlusion of the left atrial appendage to prevent stroke in atrial fibrillationWe conducted 2 feasibility studies to assess the performance and safety of the percutaneous left atrial appendage (LAA) transcatheter occlusion system for the prevention of stroke in high-risk patients with nonrheumatic atrial fibrillation. Results showed that percutaneous LAA occlusion can be performed using the device at acceptable risk. This procedure may be particularly useful for patients at increased risk of ischemic stroke with a contraindication to anticoagulation therapy.
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New Angiogenesis Inhibitor May Be Effective Against a Broad Range of CancersResearchers at Children's Hospital Boston say that they have developed the first oral, broad-spectrum angiogenesis inhibitor that may offer a potential nontoxic therapy for a wide range of cancers. The drug was formulated through nanotechnology and has shown promising anticancer results in mice.
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Considering Three Major Developments in the Diabetes Retinopathy IndustryThe DR market is expected to accrue a sum of $2,490 million by 2022, growing at a compound annual growth rate of 14.4% from 2014-2022.
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Rapid Testing for Strep Pharyngitis alone; Culture Not NeededThis was a systematic review and meta-analysis examining the accuracy of rapid antigen diagnostic tests (RADTs) for group A strep (GAS) pharyngitis in children and adults as well as differences between studies already performed.
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In Medicine, The "Soft" Skills Are EssentialToo few physicians have the “soft” communications and interpersonal skills they need to succeed in clinical settings. That’s a big and potentially deadly problem.
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Anti-inflammatory effects of pioglitazone and/or simvastatin in patients with distinct clinical risk for cardiovascular complicationsStatins are the most commonly used pharmacologic intervention in patients with increased cardiovascular risk. In addition to their beneficial effect on the atherogenic lipid profile, they have been shown to exert several pleiotrophic effects, including the reduction of low-grade inflammation. Thiazolidinediones (TZDs) are a new class of antidiabetic drugs that have been shown to improve insulin sensitivity and to reduce cardiovascular risk in patients with type 2 diabetes. Our study is the first to show a complementary effect of TZD and statin treatment on several cardiovascular risk factors in subjects without diabetes. These findings may have important implications for further discussion on cardiovascular risk reduction, especially for patients with metabolic syndrome.
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Late mortality with sirolimus-eluting stents in diseased saphenous vein graftsIn a secondary post-hoc analysis of the Reduction of Restenosis in Saphenous Vein Grafts with Cypher (RRISC) trial, we compared the long-term safety of sirolimus-eluting stents (SES) with bare-metal stents (BMS) in diseased saphenous vein grafts
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Stem Cell Transplant May Reduce Disability in Patients with Multiple SclerosisPatients with relapsing-remitting multiple sclerosis (RRMS) who received a non-myeloablative hematopoietic stem cell transplant (HSCT) experienced improved measures of disability and quality of life.
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First, Do No Harm: The Role of Medication Reconciliation in Reducing Preventable ErrorsThe Joint Commission on Accreditation of Healthcare Organizations states that medication errors continue to be one of the most frequent causes of preventable harm in healthcare. As Tangalos sees it, electronic and IT solutions hold the greatest promise to eliminate these errors.
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Is This Teenager a Good Candidate for an IUD?Although they are underutilized, intrauterine devices are among the safest and most efficacious forms of birth control available for adolescents.
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First Person: Parte for a MotherCan loss make you a better doctor? A psychiatrist reflects on his mother's death.
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Intensive statin therapy in acute coronary syndromeWe conducted a meta-analysis of 13 randomized controlled trials involving 17 963 subjects to determine the effect of intensive statin therapy instituted within 14 days of hospitalization for acute coronary syndrome. Results showed that early, intensive statin therapy is safe and significantly decreases cardiovascular death and recurrent ischemia following acute coronary syndrome after 6 months of treatment.
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Assessing risk through "inspired" careThis retrospective subanalysis of the Adenosine Sestamibi SPECT Post-Infarction Evaluation (INSPIRE) trial shows that early adenosine sestamibi stress testing is not only safe early after myocardial infarction (MI), but can also be very useful to identify patients at very low risk for events in the first year after discharge.
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High-dose statins and the high-risk vascular surgery patientIn a recently published prior paper, Dr Feringa and his colleagues called attention to the prevalence of postoperative cardiac abnormalities in patients undergoing noncardiac vascular surgery.
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The prognostic role of metabolic syndrome after myocardial infarctionWe evaluated the prognostic role of metabolic syndrome after myocardial infarction and found that metabolic syndrome correlated with an increased risk of cardiovascular events and death. The risk of developing diabetes decreased with weight loss in patients with metabolic syndrome. These results indicate that a more aggressive approach to the treatment of patients with metabolic syndrome, particularly with regard to changes in lifestyle, would be beneficial.
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Antithrombotic treatment of high-risk elderly patients hospitalized with atrial fibrillationWe assessed the pattern of use and the effectiveness of antithrombotic therapy in a cohort of high-risk elderly patients hospitalized for atrial fibrillation, with data derived from prescription, hospitalization, and mortality databases from 3 linked registries. Results showed that antithrombotic therapy was underused, even in patients with no comorbid conditions. In addition, patients exposed to antithrombotic therapy had a significantly lower mortality rate. The collection of epidemiological data by record linkage represents a flexible and readily available tool for monitoring and improving routine clinical care.
