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The Evolving Profession of Oncology Nurse NavigatorsSome of the best news that a patient can receive after being informed that they have cancer is that they have been assigned to an oncology nurse navigator (ONN).
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High clopidogrel maintenance dosage in patients with diabetes mellitus and coronary artery diseasePatients with type 2 diabetes mellitus have decreased platelet inhibition and decreased responsiveness to standard doses of clopidogrel compared with patients without diabetes. In this pilot study, we showed that increasing the maintenance dose of clopidogrel to 150 mg leads to enhanced platelet inhibition compared with the standard dose of 75 mg in patients with type 2 diabetes with suboptimal responsiveness. The clinical implications of these findings are unknown, however, and need to be evaluated in large-scale clinical trials.
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The Perfect Storm: When Parkinson Patients Enter the HospitalDiffering therapies, inaccurate regimens, missed diagnoses—issues can compound quickly for patients with PD seeking care for something else.
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Heart failure with preserved ejection fraction in womenHeart failure in the United States affects 4.9 million people, of whom 2.5 million are women.
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Acute aortic occlusion: Common presentation of an uncommon catastropheThere is scant systematic literature available on acute aortic occlusion. A review of 46 cases in a single center found 2 primary causes, including embolism (65%) or thrombosis (35%).1 Smoking and diabetes were found to be the risk factors for thrombotic occlusion and pre-existing cardiac disease and female gender risk factors for embolism. Acute aortic occlusion due to embolization of a large thrombus from left atrial appendage occurred in a patient with atrial fibrillation at our institution recently (Radha Sharma,MD, personal communication, February 2008). Case reports have described embolization of atrial myxoma to the abdominal aorta resulting in aortoiliac occlusion.2,3
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The Cure for Burnout? Reconnecting with Our PatientsPhysicians are primarily delivering disease management, rather than healing and care. The current system is a placing a strain on the practice.
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AdAlta CEO Sam Cobb Discusses IPF Therapy DevelopmentRare Disease Report sat down with AdAlta CEO Sam Cobb to discuss the impetus for the redesign of AD-214, and what it means for those in the idopathic pulmonary fibrosis.
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Making the Grade: How Doctor-grading Websites Can Impact Your Practice, and What You Can Do to Lessen the BlowShould your practice have a policy for responding to negative comments about the quality of care and service delivered by you and your staff left anonymously on an online physician-grading website?
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Medication nonadherence and adverse outcomes in CAD patientsNonadherence to beta blockers, statins, or angiotensin-converting enzyme inhibitors is common (21%-29%) among patients with coronary artery disease (CAD). Patients who do not adhere to their medication regimens are at increased risk of mortality, cardiovascular hospitalizations, and revascularization procedures; thus, medication nonadherence should be a target for quality improvement interventions to maximize the outcomes of CAD patients.
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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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Treating erectile dysfunction in nonresponders to PDE5 inhibitorsMost patients are successfully treated using PDE5 inhibitors, but if treatment failure occurs, physicians have many therapeutic options at their disposal; these options are outlined by the authors.
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Effect of Inadequate Response to Treatment in Patients With DepressionThis study sought to assess the effects of inadequate response to antidepressant treatment on healthcare resource utilization and on work productivity in patients diagnosed as having major depressive disorder.
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Triple Regimen of Direct-acting Antivirals Achieves High Sustained Virologic Response Rates in Patients with Hepatitis CResults from the PEARL-II study show treatment-experienced patients with hepatitis C genotype 1b achieved SVR rates of greater than 96% when treated with a combination of ABT 450 with ritonavir, co-formulated with ombitasvir and dasabuvir, without the need for ribavirin.
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The Neurologist's AprilAs we move into April 2011, several dates are likely foremost in the minds of all neurologists, but one might be overlooked.
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Clinical Quiz: Diagnosing Epidermolysis BullosaTake our latest 5-question quiz based on the recommended strategies of laboratory-based diagnosis of epidermolysis bullosa.
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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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24-Hour ICH Score Better Prognostic Indicator Than ICH Score at AdmissionAlthough the intra-cerebral hemorrhage (ICH) score at hospital admission is typically used to estimate the potential prognosis in stroke patients, a new study suggests that the 24-hour ICH score is a more accurate assessment.
