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The Metabolic Syndrome: Pathogenesis, Consequences, and Treatment StrategiesThe last several years have witnessed a heightened interest in the metabolic syndrome, as it has become a health issue of epidemic proportions. Several metabolic abnormalities emerge as key players in the pathogenesis of the syndrome, including insulin resistance, obesity, and inflammation. Individuals with the metabolic syndrome are at increased risk for a variety of clinical conditions, some with serious health implications, particularly diabetes and cardiovascular disease. Treatment should address the causal mediators of the syndrome, such as obesity or insulin resistance. Lifestyle modification is one of the most successful treatments for the prevention of diabetes. Pharmacotherapy for dyslipidemia or hypertension can help prevent cardiovascular complications and the development of diabetes in those at risk.
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Pharmacotherapy for chronic cardiovascular disease in womenCardiovascular drugs affect women differently than they do men because of differences in pharmacokinetics, pharmacodynamics, and physiology. Results of recent studies on the use of cardiovascular agents in women are presented, with an emphasis on the need to include an appropriate proportion of women in future studies, to adapt the dosage to the weight of the patient, and to incorporate hormonal aspects into the analysis.
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SABCS Interview SeriesThe January issue of OBTN featured highlights from the 32nd Annual San Antonio Breast Cancer Symposium (SABCS). We wrap up our SABCS coverage this month with interviews on denosumab with Alison Stopeck, MD, associate professor of medicine at the University of Arizona and director of the Clinical Breast Cancer Program at the Arizona Cancer Center; oral bisphosphonates with Rowan T.Chlebowski, MD, PhD, professor and chief of the Los Angeles Biomedical Research Institute at Harbor-University of California, Los Angeles Medical Center; and adjuvant chemotherapy�induced alopecia with Hugues Bourgeois, MD, Centre Jean Bernard in Lemans, France.
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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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Loss of CD62L on T Cells is Associated with Risk of Developing Progressive Multifocal Leukoencephalopathy in Patients Treated with NatalizumabResearchers suggest that monitoring for the loss of CD62L expression on CD4+ T cells is a biomarker for risk assessment in patients treated with natalizumab who may develop PML, since other treatments do not show this pattern of C62L loss of expression.
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11 Undeniable Truths About EHRs and Paper ChartsHow do I loathe EHRs? Let me count the ways...
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Hyponatremia from a Nephrologist's PerspectiveAnil Asgaonkar, MD, provides an overview of the signs, symptoms, and causes that are frequently associated with hyponatremia, and outlines several standard treatment approaches.
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Undiagnosed diabetes mellitus in coronary artery bypass graft surgeryWe examined the prevalence and risks associated with undiagnosed diabetes mellitus among more than 7000 patients who had undergone coronary artery bypass graft surgery. At the perioperative and postoperative stages, patients with undiagnosed diabetes showed a significantly higher morbidity and mortality rate.
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Do You Ask Your Patients with Hypertension About Dental Health?Providers should be aware that periodontal disease may hinder the efficacy of blood pressure medication.
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Improved Outcomes in Patients with Chronic Hepatitis C Treated with Sofosbuvir VelpatasvirTreatment with fixed-dos combination sofosbuvir/velpatasvir yielded significant improvements in patient-reported outcomes.
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HPV Vaccination in Adolescent Females Not Associated with Increased Incidence of Sexually Transmitted InfectionThe prevalence of HPV infection in US females aged 14-19 is approximately 25% and in females aged 20-24 it is increased to approximately 45%. Despite this high risk, in 2013, only 38% of females aged 13-17 have received all three recommended HPV vaccine doses.
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Study Finds Wide Variation in the Use of Testosterone Therapy among Veterans Health Administration FacilitiesResearchers identify limited evidence base and uneven clinical application as probable reasons for variation.
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Bilateral Acute Angle-Closure GlaucomaBilateral disease is rare but may be caused by several drug classes. Physicians need to consider these medications and other etiologies in their differential diagnosis to ensure prompt and appropriate treatment.
