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Updates in Surgery: Percutaneous Coronary Intervention, Perioperative Biomarkers, and TroponinDuring a follow-on session at the 2013 Southern Hospital Medicine Conference, Steven Cohn, MD, discussed the effect of PCI on subsequent non-cardiac surgery outcomes, monitoring specific hormone levels as indicators of cardiovascular risk, and other hot topics in perioperative medicine.
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Outcomes in women vs men with heart failure and preserved ejection fractionThe epidemiologic finding that women with heart failure have better overall survival than men may be because of the higher prevalence of diastolic heart failure or heart failure with preserved ejection fraction (HF-PEF) among women.
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Melanoma: Improving Clinical Outcomes Through Advances in Immunotherapeutics and Targeted TherapyMetastatic melanoma has limited treatment options, but advances in the understanding of the oncogenic mutations that drive this cancer and how the immune system can be better modulated to fight melanoma provide a new generation of active approaches for patients.
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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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A Tour of Hospital Medicine in the BlogosphereWith the ranks of hospitalists already over 20,000 strong and growing every day, hospital medicine is the fastest-growing medical specialty in the history of American healthcare
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Uncovering masked hypertension: Is the blood pressure really normal?A number of studies have documented the incremental predictive ability of 24 hour ambulatory blood pressure (BP) monitoring over traditional office or casual BP monitoring for predicting adverse cardiovascular events.
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A Sense of Urgency in Sanfilippo Therapy DevelopmentWith no real standard-of-care for Sanfilippo syndrome patients, Brian Bigger, Ph.D., discusses the sense of urgency he and his colleagues feel while researching.
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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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Are statins cardioprotective in patients undergoing major vascular surgery?We evaluated the cardioprotective effects of intensive statin therapy before major vascular surgery in a prospective study of 359 subjects. After multivariate analysis, lower low-density lipoprotein (LDL) cholesterol was associated with decreased myocardial ischemia, troponin T release, and 30-day and late cardiac events. Furthermore, higher doses of statins were associated with better cardiac outcome, even after adjusting for LDL cholesterol.
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What Role Do Muscle Building Supplements Play in Testicular CancerWith muscle supplements being a popular addition to exercise regiments their potential health risks also remain a concern.
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Taking Steps to Reduce Cardiovascular Outcomes in a High-risk PopulationFamily physicians should place as great an emphasis on walking as they do on monitoring medication and laboratory data, and strongly recommend increased ambulatory activity to their patients.
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Survival after heart failureWe conducted a multi-hospital population-based study of 2445 residents of a large New England metropolitan area hospitalized with acute heart failure and found that the long-term prognosis for these patients remains poor. More than one third of patients died in the first year after hospital discharge,and nearly 4 of 5 patients died over the 5-year follow-up period. Several demographic and clinical factors were associated with an adverse prognosis. It is important to know the factors that negatively affect long-term survival after hospital discharge for decompensated heart failure so that treatment can be directed toward specific high-risk groups.
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Contemporary cardiac imaging in hypertrophic obstructive cardiomyopathyFeatures of hypertrophic obstructive cardiomyopathy (HOCM) include obstruction at the left ventricular outflow tract (caused by a markedly thickened proximal interventricular septum) and systolic anterior motion of the mitral valve. The case discussed here illustrates several classic features of this disease including clinical presentation, diagnostic workup, and noninvasive and invasive management.
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Atrial fibrillation after cardiac surgeryWe assessed preoperative cardiac physiology using echocardiography in patients undergoing cardiac surgery to identify predictors of postoperative atrial fibrillation. Subjects with enlarged left atrial volume had a 5-fold greater risk of postoperative atrial fibrillation, independent of age and other risk factors, than those without enlarged left atrial volume. Left atrial volume appears to be a powerful tool to stratify patients according to risk before surgery and to effectively target preventive therapy.
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A Caregiver's Perspective: Light Chain (AL) Amyloidosis TreatmentSusan Weisman, a light chain (AL) amyloidosis caregiver for her husband since 2009, touches on a few of her husband's treatments in an approximate timeline.
