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Can corticosteroids prevent atrial fibrillation after cardiac surgery?We conducted a prospective, double-blind, randomized, multicenter study among 241 patients who underwent their first on-pump coronary artery bypass graft (CABG) surgery, aortic valve replacement (AVR), or combined CABG and AVR surgery to determine whether the use of hydrocortisone prevents atrial fibrillation after cardiac surgery. Results showed that the incidence of postoperative atrial fibrillation was significantly lower in the hydrocortisone group compared with the placebo group.
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Treating erectile dysfunction in nonresponders to PDE5 inhibitorsMost patients are successfully treated using PDE5 inhibitors, but if treatment failure occurs, physicians have many therapeutic options at their disposal; these options are outlined by the authors.
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FDA Approves Phentermine and Topiramate Capsules for Pediatric Chronic Weight ManagementThe approval, which was was supported by data from a 56-week trial involving 223 obese individuals 12-17 years old, recommended the capsules be used in conjunction with a reduced-calorie diet and increased physical activity.
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Excess Weight Linked to Increased Risk of Developing Rheumatoid ArthritisOverweight women face a higher risk of rheumatoid arthritis than their normal-weight peers, according to a study presented at the annual scientific meeting of the American College of Rheumatology in Washington, DC.
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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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Tough Financial Times May Lead to Increased ObesityPublic health scientists say they're worried that a downtrodden economy will make Americans more overweight than ever before.
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Addressing Treatment Challenges and Advancing Care in PsoriasisAn examination of the physical, emotional and social burden of psoriasis, and the continued need for research to advance care for patients.
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Concurrent Trastuzumab with Chemotherapy Optimal RegimenA study recommends use of trastuzumab concurrently with the taxane portion of chemotherapy for breast cancer patients.
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Continuing Controversy Over the Value of Routine Mammography ScreeningTo screen or not to screen for breast cancer with mammograms: that is the question faced by thousands of physicians confronting a disease that accounts for more than 230,000 cases and 40,000 deaths each year in the United States.
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Contemplating Suicide: A Physician's Guide to Dealing with the Suicidal PatientSuicide is often viewed as "a permanent fix to a temporary problem." Unfortunately, for many individuals, attempting suicide is the answer. Estimates suggest there are from 8 to 25 suicide attempts for every one completion. As more lethal methods are used, the number of completed suicides increases. Physicians often see patients in the month before completion of the act. To provide effective treatment, they must be aware of the risks, particularly the red flags that indicate imminent risk in their patients.
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Is Lung Cancer Screening Cost Effective?The National Lung Screening Trial, published in 2011, demonstrated that annual screening with low-dose computed tomography reduced lung cancer mortality by 20% among people aged 55-74 years. This data applied to people who had a smoking history of at least 30 pack-years and either continued to smoke or had quit within the last 15 years. This study examined the cost-effectiveness of this program.
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Honesty Is the Best Policy: Effective communication is essential for achieving a good death.Every day, an oncology nurse has a conversation with a patient that goes something like this: The patient asks, How much longer do you think I can live with this aggressive tumor?
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Are Gaucher Disease and Parkinsons Linked?Rare Disease Report sits down with Simon Heales, Ph.D., Professor of Clinical Chemistry at Great Ormond Street Children’s Hospital in London who discusses a potential link between Gaucher disease and Parkinson’s disease.
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Asystole during sleep in a 46-year-old male athleteA number of electrocardiographic abnormalities have been described in athletes.1 Among these are sinus bradycardia and varying degrees of atrioventricular (AV) block. These findings have been attributed to the "athlete's heart," and are felt to be due to enhanced vagal tone seen with excellent physical conditioning. Secondarily it has also been suggested that there are intrinsic changes within the sinoatrial and AV nodes themselves, including prolonged sinus node recovery time and AV nodal Wenckebach, and these abnormalities persist following autonomic blockade.
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Incidence of death and MI associated with stopping clopidogrel after ACSRates of death and myocardial infarction were assessed for a national sample of acute coronary syndrome patients after stopping clopidogrel. In the first 90 days after stopping treatment, patients experienced a nearly twofold increased risk of adverse events compared with subsequent follow-up intervals for patients treated medically without stents and for patients treated with coronary stents. This suggests a possible clopidogrel rebound effect, but additional studies are needed to support this hypothesis and to identify strategies to reduce early events after clopidogrel cessation.
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The Generalist's Approach to the Assessment and Management of Patients Suffering with Chronic PainCommunication skills, a better understanding of the presentation of chronic pain, and a methodical approach to evaluation and treatment are the keys providing better pain care. Chronic pain is a common clinical presentation, yet many physicians remain apprehensive and feel reluctant about caring for patients with this condition.
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Clinical Pearls on Lipid ManagementA panel of expert cardiologists share their clinical pearls for managing patients with hyperlipidemia.
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FCS and the Need for TreatmentsThis past year, James A. Underberg, MD, MS, FACPM, FACP, FASPC, FNLA, President of the National Lipid Association (NLA), outlines familial chylomicronemia syndrome (FCS) and the need for treatments, which may not be far.
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Incidence of death and MI associated with stopping clopidogrel after ACSRates of death and myocardial infarction were assessed for a national sample of acute coronary syndrome patients after stopping clopidogrel. In the first 90 days after stopping treatment, patients experienced a nearly twofold increased risk of adverse events compared with subsequent follow-up intervals for patients treated medically without stents and for patients treated with coronary stents. This suggests a possible clopidogrel rebound effect, but additional studies are needed to support this hypothesis and to identify strategies to reduce early events after clopidogrel cessation.
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Iatrogenic dilated cardiomyopathy and spectrum of current treatment modalitiesOur increasing ability to intervene in high-risk patients—with lower risks and greater chances for successful outcomes—is felt across the broad spectrum of cardiovascular disease. This is particularly evident in patients with dilated cardiomyopathy (DCM).
