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Managing Obesity Through PharmacologyObesity contributes to significant morbidity and mortality among primary care patients. This paper summarizes options for pharmacological management of obesity. Medications approved for obesity are Phenteremine/Topiramate, Orlistat, Lorcaserin, Naltrexone/Bupropion, Liraglutide.
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Eat Fiber: One Simple Message for Weight LossThis study was a randomized, controlled trial of 240 adults with metabolic syndrome who were assigned to follow either the single-component dietary recommendation of increased fiber consumption (≥30g/d), or the multi-component American Heart Association (AHA) dietary guidelines. The primary outcome measure was weight loss at 12 months.
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Acquired Angioedema: A Challenging DiagnosisAngioedema is a hypersensitivity disorder that presents as edema of the subcutaneous tissues and mucosa, typically involving the upper airways or gastrointestinal tract, and often accompanied by urticaria. Although this condition could be either hereditary or acquired, the causes often overlap, with similar clinical manifestations. Diagnosis requires laboratory testing to determine serum complement levels. Treatment must be directed toward the resolution of the acute symptoms and prevention of recurrence.
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Physicians to Take a Big Pay Cut from MedicareDear doctor, Congress is once again just kicking the can (your Medicare fees) further down the road.
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Folding@home: How Distributed Computing Is Unraveling the Mysteries of Protein FoldingIn October 2000, a team of researchers at Stanford University led by Vijay Pande, PhD, debuted a distributed computing project designed to simulate the protein folding process.
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An Open Letter to the Woman at the SupermarketA little small talk in the produce section illustrates the challenges of small-town doctoring.
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Comprehensive lifestyle modification and blood pressure controlLifestyle recommendations for the prevention and treatment of hypertension include weight loss, reduced sodium intake, increased physical activity, limited alcohol intake, and the Dietary Approaches to Stop Hypertension (DASH) diet. The 18-month results of the Prospective Registry Evaluating Myocardial Infarction: Events and Recovery (PREMIER) randomized clinical trial showed that individuals with prehypertension and stage 1 hypertension can make and sustain many of these lifestyle changes over the long term, thereby reducing their risk of cardiovascular disease.
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Thoracic and abdominal aorticatherosclerosisIt was not until Virchow identified the cellular contributions to thrombosis that physicians began to visualize arteries as dynamic tissues.
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Predicting survival in elderly patients with heart failureOver a period of 14 years, we followed 282 patients aged 70 years or older who were hospitalized with heart failure. Median survival was 2.5 years, but 25% of patients died within 1 year, and 25% survived for at least 5 years following hospital discharge. A simple 7-item risk score based on data readily available at the time of hospitalization effectively stratified patients into low-, intermediate-, and high-risk categories for subsequent mortality.
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Tablet PCs Have Finally Arrived in Health CareAfter years of false starts and disappointing products and software, a new generation of tablet PCs, led by the Apple iPad, appears poised for widespread adoption in the clinical setting. What makes the current crop of devices so useful for busy physicians? It all comes down to the perfect combination of form and function.
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Long-term diuretic use and increased mortality and hospitalization in heart failureDiuretic use has long been a mainstay in the management of symptomatic heart failure with pulmonary or systemic congestion, or both.
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Maintaining sinus rhythm after cardioversion of atrial fibrillationWe performed a meta-analysis of the effect of long-term treatment with antiarrhythmic drugs for the prevention of recurrent atrial fibrillation after conversion to sinus rhythm. We found that several class IA, IC, and III drugs are effective in maintaining sinus rhythm, but virtually all of them increase adverse effects, including proarrhythmia. In addition, class IA drugs are associated with increased mortality. The final risk-benefit ratio of antiarrhythmic drugs on clinically relevant outcomes is still unclear.
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Assessing COVID-19 MortalitySwiss researchers propose a new method to assess COVID-19 mortality.
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Fit Teens Manage Pain Better, Study FindsPhysically active adolescents appear to handle exercise-related pain better than inactive adolescents, a study found.
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Acute aortic occlusion: Common presentation of an uncommon catastropheThere is scant systematic literature available on acute aortic occlusion. A review of 46 cases in a single center found 2 primary causes, including embolism (65%) or thrombosis (35%).1 Smoking and diabetes were found to be the risk factors for thrombotic occlusion and pre-existing cardiac disease and female gender risk factors for embolism. Acute aortic occlusion due to embolization of a large thrombus from left atrial appendage occurred in a patient with atrial fibrillation at our institution recently (Radha Sharma,MD, personal communication, February 2008). Case reports have described embolization of atrial myxoma to the abdominal aorta resulting in aortoiliac occlusion.2,3
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Social Media Plays Key Part in Medicine TodayWhen patients leave the waiting room of their provider, their concerns can go with them. With the help of social media channels like Facebook and Twitter, those concerns can be addressed while information is shared in a new and effective manner.
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Nonadherence to cardiac medications: An important considerationIn a well-done recent study, Dr P. Michael Ho and colleagues confirm previous data and clinical observations that many patients are nonadherent to their cardiac medications, and, importantly, this nonadherence adversely impacts outcomes, including cardiovascular mortality.
