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Coronary angiography revealing a rare anomalyA 48-year-old man with a history of type 2 diabetes was referred to our outpatient clinic for preoperative evaluation before undergoing intrabdominal surgery. He reported recently aggravated chest discomfort at rest.
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47th Annual Gastroenterology Update: Rationale for Combination Therapy in Inflammatory Bowel DiseaseDr. Jean-Paul Achker said there is room for improvement of response rates with current treatment approaches. "There may be a limited window of time to maximize anti-TNFα therapy, as evidenced by the observed loss of response over time, the need to increase the dose of anti-TNFα therapy, and immunogenicity," he said.
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Does low on-treatment diastolic blood pressure influence prognosis in systolic hypertension patients?From the Hypertension and Cardiovascular Rehabilitation Unit, Department of Cardiovascular Diseases, University of Leuven, Leuven, Belgium.
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Renal dysfunction in older age groups and mortality after acute myocardial infarctionOnly one third of patients admitted to the hospital with acute myocardial infarction have normal renal function, and 17% have severe renal impairment. Decreased renal function is associated with the presence of comorbid conditions, underuse of effective treatments, and higher mortality. Renal function parameters should not only be included in scoring systems to assess risk levels, but patients with abnormal renal function should benefit from careful application of guidelines-recommended treatments for acute and long-term care.
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Vested Self-interest: A Conflict of Interest in MedicineThe doctor-patient relation is not symmetric -- it is a relation of trust.
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Symptomatic carotid plaques and ischemic symptomsWe assessed the histologic features of 526 carotid plaques from consecutive patients undergoing endarterectomy for symptomatic carotid stenosis and found a high prevalence of coronary-type plaque instability, with strong correlations between macrophage infiltration and both cap rupture and time since stroke. Temporal trends were much weaker after a transient ischemic attack than after a stroke, with a tendency for plaque features to persist for a longer period, suggesting heterogeneity in the underlying pathological mechanisms.
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Lipid-lowering therapy and atherosclerotic aortic plaquesWe showed that a significant reduction in thoracic aortic plaques and low-density lipoprotein cholesterol levels occurred after 12 months of treatment with atorvastatin. In the abdominal aorta, however, the change in atherosclerotic plaques correlated with age. These results show that plaques in the thoracic and abdominal aortas may respond differently to lipid-lowering therapy, and other factors, such as aging, may be more important for plaque progression in the abdominal aorta.
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Diabetes-related Complications: US Trends in the Last 20 YearsThe incidence of type 2 diabetes mellitus tripled in the last 20 years. What has that meant for rates of complications?
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Overcoming the Hurdles to EHR AdoptionA survey conducted by the Institute for Health Policy between late 2007 and early 2008 found that only 4% of physicians are using a fully functional EHR.
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F-fluoride PET to ID Ruptured and High-risk Coronary Atherosclerotic PlaquesThe optimal duration of DAPT following PCI with drug-eluting stents remains dubious.
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Is warfarin a safe alternative to aspirin in elderly patients with atrial fibrillation?We recruited 973 patients (mean age, 81 years) with atrial fibrillation from the primary care setting and randomly assigned them to receive anticoagulation with warfarin or aspirin.
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Clinical Systems Support Decision-making and Improve SafetyIn my 15 years of oncology/hematology nursing experience, I�ve seen many errors and near-errors. No one is exempt from making mistakes, regardless of their experience level, and even a seemingly simple oversight can be dangerous for patients.
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Healthcare IT Still Seeks a Security BlanketAugust has traditionally been a sleepy month for government regulatory agencies, but this year, Washington's usual summer torpor was interrupted by a rush of new initiatives, as more than three-quarters of a trillion dollars from the American Recovery and Reinvestment Act surged into a mind- boggling range of projects.
