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We examined the association between plasma N-terminal pro-brain natriuretic peptide (Nt-pro-BNP) levels and the occurrence of cardiac events, including cardiogenic shock and mortality, among hospitalized diabetic patients with acute myocardial infarction. Nt-pro-BNP level was shown to be a reliable predictor of outcome in this group of patients.

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We evaluated the accuracy of the 64-slice computed tomography (CT) angiography scanner in subjects who were scheduled to undergo invasive angiography for possible stenosis in coronary artery bypass grafts. Results showed that the improved resolution of CT scanners with 64-slice technology allowed for a precise delineation of bypass graft occlusion or stenosis. It permitted an accurate noninvasive assessment of bypass grafts, even in subgroups of subjects with suboptimal scan conditions, such as those with arrhythmias or higher heart rates.

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Large organizations with mobile workers, such as hospitals, face diminished productivity when communication is inefficient and its employees are unable to locate their coworkers in a timely manner.

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As we age, the limitations on where we live and how we can live increase.

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Collaboration is important in healthcare, as evidenced by the growing number of "learning communities" and grassroots efforts that are bringing people and organizations together to work on the issue of eliminating disparities in health and healthcare.

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More than one technology pundit has claimed that desktop software and computing that relies on local servers is on life support, soon to be replaced by an Internet-based approach that relies on a "cloud" of applications and virtual resources that are delivered over the Web via your browser. Are proponents who want to apply this concept to EMRs correct when they say that this is the future of health IT, or do they have their head in the clouds?

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The reported rate of outpatient visits for influenza-like illness increased to 4.1%—well above the national baseline of 2.2%, and 1.5% greater than the rate reported midway through December.

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Our 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.

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Up to 100 sudden deaths occur among high school and college athletes each year in the United States, most commonly resulting from hypertrophic cardiomyopathy and other cardiac disorders. Studies have shown that preparticipation screening examinations that include a 12-lead electrocardiogram, which is not currently required in the United States, can identify asymptomatic athletes with hypertrophic cardiomyopathy. The current dilemma is how the United States, with its large population and emphasis on reducing health care costs, can realistically implement an effective prescreening process to identify these athletes.

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In each issue of MDNG, we will showcase a post by one of the HCPLive.com bloggers. This month, we have selected a post from The Nerve Center, written by Victor G. Dostrow, MD.

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In journals for cardiac surgeons and anesthesiologists, the term heparin rebound has predominantly described an anticoagulant condition. In journals for cardiologists and internists, however, the term has been used to describe a procoagulant state. Because precision is one of the fundamental rules in medicine, it may be helpful to foster a more precise understanding of this term.

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Dr. Lubin provides more examples that show why the title of his blog, "Code E876.9: Unspecified Misadventures During Medical Care" is so appropriate.

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We evaluated the risk and timing of sudden death among high-risk patients after myocardial infarction (MI). Among survivors of acute MI with reduced left ventricular systolic function or heart failure, or both, the risk of sudden death from cardiac causes was highest in the first 30 days after MI. These findings indicate a need for early intervention to prevent sudden death during this vulnerable period.

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In recent years, physicians' thinking has changed when it comes to evaluating pain in patients. Now, rather than looking at pain as being merely a symptom of an underlying disorder, many clinicians are now focusing on the pain itself, and changing their approach to how they treat it.

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Pain management protocols for women undergoing C-sections, that include a non-opioid option such as EXPAREL, can help improve pain management and reduce the need for opioids.

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We performed cineventriculography, unenhanced echocardiography, contrast-enhanced echocardiography, and magnetic resonance imaging to define the presence of regional left ventricular wall motion abnormalities. Interobserver agreement in the analysis of regional wall motion abnormality was highest for contrast-enhanced echocardiography, followed by cineventriculography and cardiac magnetic resonance imaging; it was lowest for unenhanced echocardiography. Contrast-enhanced echocardiography also showed the highest accuracy in the detection of panel-defined regional wall motion abnormalities.

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We found sex differences in the pattern of relative strength when riskfactor associations with death from cardiovascular disease (CVD) were evaluated across different periods of follow-up. In women, an increased risk in CVD-related death was associated with diabetes mellitus and smoking; this risk was most prominent in the early follow-up period. Our finding illustrates that clinicians should employ more intense preventive measures in women who are smokers or have diabetes.

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We developed a set of equations to predict the risk or probability of developing coronary artery disease (CAD) in 10 years among American Indians. The equations are based on the significant risk factors identified in the Strong Heart Study, a longitudinal study of cardiovascular disease in American Indians. The equations can be used in patient education and to evaluate the efficacy of CAD prevention and intervention programs.

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Over 10 years, lifestyle intervention and metformin were cost-effective or cost saving compared with placebo.

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The tuberculin skin test is the most frequently used method for detecting asymptomatic latent tuberculosis infection. There is growing interest in other diagnostic tests for latent infection that might be simpler to administer, but the tuberculin skin test remains the preferred modality because of its ease of use and low cost. The decision to perform an annual test or a single test depends on the population each specific patient represents. Interpretation of the reaction to the test should be done by trained health care professionals, keeping in mind that factors such as immunization can cause false-negative or false-positive results.

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Postpartum cardiomyopathy is a serious disorder that can present from the third trimester to up to 5 months after pregnancy. Although spontaneous resolution of cardiac function occurs in more than half of patients (over a period of 6-12 months), the balance is left with persistent cardiac dysfunction. Cardiac dysfunction results in signs and symptoms of left heart failure, formation of apical or left ventricular thrombi, and arrhythmias and requires management similar to that in patients with nonischemic dilated cardiomyopathy.

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