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Initiating treatment for chronic heart failureStandard congestive heart failure treatment begins with an angiotensin-converting enzyme (ACE) inhibitor to which a beta-blocker is added once the target dose of the ACE inhibitor has been reached. We compared morbidity and mortality between standard treatment and treatment using the reverse sequence, that is, the beta-blocker bisoprolol was given to patients first, followed by the ACE inhibitor enalapril. Results showed that both sequence strategies were safe and effective, with a survival trend in favor of the bisoprolol-first strategy.
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Recognizing Posttraumatic Stress Disorder and Its ComorbiditiesPosttraumatic stress disorder is the fourth most common psychiatric condition, affecting about 1 in 10 people at some point during their lifetime. The principal cause is exposure to an extremely traumatic event. The individual's unique biologic or psychosocial character and previous exposure, along with the personal significance of the trauma, shape the intensity of the response. Early recognition of trauma symptoms and signs and prompt intervention are important in the prevention of acute stress disorder and the subsequent development of posttraumatic stress disorder. Obtaining a trauma history during a routine medical examination can lead to the diagnosis and help initiate treatment. In addition to being distressing, symptoms also diminish quality of life, impair psychosocial adjustment, and worsen overall health.
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Low cholesterol, statins, and cancer risk: Déjà vu all over againThere has been an epidemiologic association of low total cholesterol levels with increased risk of cancer noted for several decades.
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Social Media: Healthcare's Proving GroundPhil Baumann, a registered nurse, blogger, owner of brand Web presence consulting firm CareAdvocate, and author of "140 Healthcare Uses for Twitter" explains why he thinks social media is important in healthcare, and offers advice for physicians who want to use these tools in their practice.
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Meckel's Diverticulum in Adults: More Common Than You ThinkMeckel's diverticulum is among the most common congenital defects of the gastrointestinal tract. Although often considered a disorder of childhood, it can also be diagnosed in adults. Meckel's diverticulum is often asymptomatic. When patients present with symptoms, diagnosis is complicated because the features are similar to those of many other gastrointestinal conditions, and traditional imaging studies often do not demonstrate an obvious abnormality. Management is evolving, and there is no consensus on the appropriate approach to treatment. This article discusses the pathophysiology, associated complications, and management options for this often-overlooked condition.
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Rivastigmine Patch Shows Global Benefit in Severe Alzheimer's DiseasePatients with advanced Alzheimer's disease treated with 13.3 mg rivastigmine patch showed greater improvements in cognitive, functional, and behavioral performance from baseline compared to patients who received 4.6 mg patches.
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How Supplemental Newborn Screening Could Improve Patient CareGenetic testing for medical conditions can be controversial, especially when it concerns newborns. Alan Copperman, MD discusses why the benefits outweigh the concerns.
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New Rules and Credit ScoresWhen the ground rules changed for credit card issuers, some of the rules for consumers looking to keep their credit score high changed too. Certain moves, which used to be no-nos, can now actually improve your credit rating.
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Politics & Policy: March 2007The Politics and Policy page provides a concise and timely round-up of key government-related oncology and biotechnology news. Content is focused upon the public sector activities that are most likely to impact the evolving oncology and biotech industries.
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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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Watch for these Studies at AHA Scientific SessionsThe American Heart Association's Scientific Sessions 2016 gets underway in New Orleans, LA, this weekend. Here are some studies to watch for.
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Syncope from ventricular tachycardia secondary to methadone useMethadone HCI (Diskets, Dolophine, Methadose) is a synthetic opioid that has been used widely in the United States for the management of heroin addiction Treatment of opioid dependence has been shifting gradually from the older US Food and Drug Administration (FDA) inspection program, ...
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Leveraging Telemedicine During the COVID-19 OutbreakTelemedicine platforms can be used to monitor symptoms remotely and reduce overcrowding in healthcare facilities.
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New-Onset Diabetes and Ketoacidosis in a Patient Treated with OlanzapineSeveral case reports published since the introduction of atypical antipsychotics suggest an association between these medications and both new-onset diabetes mellitus and diabetic ketoacidosis. The latter is a potentially life threatening medical emergency. We report the case of a 41-year-old African American woman with schizophrenia who developed type 2 diabetes and ketoacidosis 7 months after commencing olanzapine therapy. This case adds to the evidence in the literature that patients who develop ketoacidosis while taking antipsychotic medications tend to be female and relatively young, a disproportionate number of whom are African American. The frequency of these reports suggests that clinicians should monitor serum glucose levels periodically in all patients treated with atypical antipsychotics, particularly in those at increased risk for diabetes.
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Aspirin and clopidogrel after recent ischemic stroke or transient ischemic attackThe recent Management of Atherothrombosis with Clopidogrel in High-risk Patients Trial showed that adding acetylsalicylic acid (aspirin) to clopidogrel in high-risk patients with recent ischemic stroke or transient ischemic attack is associated with a favorable but nonstatistically significant trend toward fewer vascular events. However, the risk of life-threatening bleeding is increased by the addition of aspirin to clopidogrel. These results do not support the routine use of aspirin in addition to clopidogrel in the patient population that was studied in MATCH.
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White-coat hypertension and progression to home hypertensionOur study aimed to clarify whether white-coat hypertension represents a transient state in the development of hypertension outside medical settings. We followed up 128 subjects with white-coat hypertension and compared their risk of progression to home hypertension with that of 649 sustained normotensive subjects. After 8 years of follow-up, subjects with white-coat hypertension had an approximately 3-fold higher risk of eventually manifesting home hypertension. We concluded that patients with white-coat hypertension should be carefully monitored.
