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Anomalous origin of the right coronary artery in an asymptomatic athlete: What if he did not have a murmur?Sudden death in young athletes is shocking because it is unexpected in these seemingly healthy individuals. We present the case of an athlete who was found to have an incidental murmur during a screening physical, which led to a diagnosis of an anomalous origin of the right coronary artery with an intramural course. This congenital anomaly has been well recognized to result in sudden death; thus, it was fortunate that the condition was identified in our patient. We provide a brief overview of the literature, discuss the challenges faced in diagnosing such coronary abnormalities, and review the various management options that are available.
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Aspirin plus warfarin therapy: Better alternatives availableThe study by Andreotti and Testa from Rome, Italy, was a retrospective lit erature review and meta-analysis of treatment with aspirin and warfarin (Coumadin) in survivors of acute coronary syndromes.
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Reimbursement and Managed Care News: June 2007Topics covered in this issue include: 1) High Cancer Drug Costs Altering the Research and Treatment Dynamic 2) $128 Million Settlement to Physicians 3) Coinsurance Change for Medicare Beneficiaries for Colon Cancer Screening 4) Managed Care Penetration: Not a Source of Significant Variation in Rectal Surgery Follow-up 5) Specialty Pharmacy Distributors Likely to Be the Norm for Oncology Agents 6) Better Practices for Cancer-Related Infections 7) Radioimmunotherapy Underutilized in Lymphoma?
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Twelve Things I Hate About BenzodiazepinesBenzodiazepines are commonly prescribed medications, and there are a number of misconceptions among laypeople about their proper use, so they deserve a thorough discussion.
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Increased Mortality Associated with Digoxin in AF PatientsAlthough digoxin has a very long clinical history, no randomized controlled trial has evaluated the use of digoxin for atrial fibrillation (AF). Therefore, the evidence for its use in AF is based on post hoc analyses of RCTs or on findings from observational studies. Several studies have shown the association of digoxin use with increased mortality rates. However, other studies have reported the opposite conclusions, and it remains controversial whether digoxin use is associated with increased mortality in patients with AF.
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Are Gender Disparities in Depressive Disorders Real? A Study of an Incarcerated PopulationMany studies have shown higher rates of depressive disorders in women than in men, with a female-to-male ratio of approximately 2:1. We examined gender characteristics in a jail setting to test the hypothesis that depression is much more common in men than has previously been reported. This setting provided a unique opportunity to diagnose and treat men with depressive disorders who would be less likely to be diagnosed with depression outside prison.
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The cost of failureWhen considering the article by Goldberg and colleagues, it seems reasonable to request a change in the title to "Survival after the diagnosis of  heart failure."
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SMS Continues to Be Most Powerful Tool in mHealthOver the past few years there has been an increasing amount of mobile technologies that enhance the ability to access public health information and improve the delivery of health services to the public at large, as well as to health care professionals. The ubiquity of cell phones makes SMS text messaging the natural platform to deliver these interventions.
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News Reports: May 2007News items featured in this month's issue: 1) Preventive Health Exams May Lead to Cancer Screenings by Prachi Patel-Predd 2) Canine Cancer Vaccine Being Investigated for Use in Humans by Diane West 3) Antirejection Drug Shows Promise In Preventing Lung Cancer in Smokers by Diane West 4) Colon Cancer Survival Linked to Number of Lymph Nodes Examined by Querida Anderson 5) Combined Therapies Improve Breast Cancer Survival by Prachi Patel-Predd 6) Mapping the Cancer Genome by Nick Rose 7) Gleevec May Decrease Risk of Recurrence in Patients with Primary Gastrointestinal Stromal Tumor by John D. Zoidis, MD 8) Dendreon Closes in on Offering First Prostate Cancer Vaccine by Nick Rose 9) PSA Kinetics is a Poor Predictor of Lethal Prostate Cancer by Querida Anderson
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The Digital Doctor: The Next Big Leap in HealthcareTechnology has grown exponentially in the same period of time when healthcare has stayed steady in practice. Soon, the pair will expand rapidly, together.
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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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How to Find Money Under Your Own RoofIf someone told you there are thousands of dollars hidden somewhere in your building, would you look for it? Medical practices are prime candidates for a cost segregation study, which can save thousands in taxes.
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Addressing Maternal MortalityMaintaining awareness of the signs of postpartum hemorrhage and preeclampsia/eclampsia is a fundamental step toward lowering the rate of maternal mortality in our country.
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GPS for the Body: Treating a Moving TargetA common treatment option for prostate cancer is radiation therapy, which is as effective in treating the disease as surgical removal of the prostate.
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How Does IT Affect Quality of Care?Oncology practices across the country are using computer technology to improve outcomes and quality of care for our patients.
