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HIV Professionals Write Letter to CongressThe HIV Medicine Association, the American Academy of HIV Medicine, The Association of Nurses in AIDS Care and the Ryan White Medical Providers Coalition have written to US Senators urging them not to repeal the Affordable Care Act.
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When You Take Time OffWhat happens to your practice when you are out of the office? This is of particular relevance to solo practitioners.
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Undiagnosed diabetes mellitus in coronary artery bypass graft surgeryWe examined the prevalence and risks associated with undiagnosed diabetes mellitus among more than 7000 patients who had undergone coronary artery bypass graft surgery. At the perioperative and postoperative stages, patients with undiagnosed diabetes showed a significantly higher morbidity and mortality rate.
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Setting A1c Goals for Patients with Diabetes Depends on a Variety of FactorsClinicians should consider a patient's risk of hypoglycemia, the duration of time with the disease, age, comorbidities, vascular complications, and other factors when setting treatment goals.
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Colonic Carcinoids: Recognizing the Signs, Sites, and Treatment OptionsCarcinoids are rare neuroendocrine tumors. More than 75% of patients present with cutaneous flushing and diarrhea. About 8% of these tumors occur in the colon. Carcinoid tumors are recognized by their histologic patterns seen on Masson's stain, Grimelius'stain, and immunohistochemistry and in situ hybridization. Evidence of the elevation of 2 biochemical markers?plasma chromogranin A and urinary 5-hydroxyindoleacetic acid?is usually sufficient for diagnosis. This article discusses the diagnosis, localization, and current and investigational treatment options for carcinoids of the colon.
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Our Move to an EHRThe initial capital outlay for transitioning to an EHR is not small. In fact, cost is one of the main reasons practices have been slow to adopt EHRs.
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The Quality Assurance Committee - No One Expects the Spanish InquisitionResponding to the public's demand to seek redress for injuries, real or imagined, at the hands of physicians, the established forces of organized medicine have turned inward in an attempt to better police their members. Out of these good intentions came the QA departments, to be found now in every hospital, HMO, and clinic. Their mandate is to weigh accusations, often brought secretly; investigate, often done selectively; deliberate, often done behind closed doors; and sentence, often without chance of appeal.
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Moderna, Pfizer COVID-19 Vaccines Do Not Affect Male FertilityThe vaccines did not result in reductions in semen volume, sperm concentration, sperm motility, and total motile sperm count.
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Traditional risk factors across short-, intermediate-, and long-term follow-up in men and womenWe 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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Undiagnosed diabetes mellitus in coronary artery bypass graft surgeryWe examined the prevalence and risks associated with undiagnosed diabetes mellitus among more than 7000 patients who had undergone coronary artery bypass graft surgery. At the perioperative and postoperative stages, patients with undiagnosed diabetes showed a significantly higher morbidity and mortality rate.
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Recognizing the Signs of PheochromocytomaPheochromocytoma is a rare chromaffin cell neoplasm that secretes catecholamines and is usually found in the adrenal medulla. One fourth of these tumors are the result of genetic inheritance. Hypertension is the most common symptom. The classic triad of paroxysmal symptoms?consisting of palpitations, diaphoresis, and headaches?should prompt a consideration of this diagnosis and appropriate laboratory testing. The best biochemical marker is plasma free metanephrines, which is 99% sensitive and 89% specific for diagnosis. Magnetic resonance imaging and radioactive iodine metaiodobenzylguanidine scans are used to localize the tumor before surgery.
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Metadata: An Orwellian Big Brother within Electronic Medical RecordsConsider this hypothetical situation: A patient with new onset of a major depression is evaluated by a physician who has found no evidence of suicidal ideation.
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The prognostic role of metabolic syndrome after myocardial infarctionWe evaluated the prognostic role of metabolic syndrome after myocardial infarction and found that metabolic syndrome correlated with an increased risk of cardiovascular events and death. The risk of developing diabetes decreased with weight loss in patients with metabolic syndrome. These results indicate that a more aggressive approach to the treatment of patients with metabolic syndrome, particularly with regard to changes in lifestyle, would be beneficial.
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Insight into a Forgotten Disease: Lemierre's SyndromeLemierre's syndrome is characterized by oropharyngeal infection, usually by Fusobacterium necrophorum, followed by septic thrombophlebitis of the internal jugular vein with embolization to the lungs and other organs. Since the introduction of antibiotics, Lemierre's syndrome has become relatively rare and is usually unsuspected until blood culture results are available. In the preantibiotic era, ligation of the internal jugular vein on the affected side to prevent septicemia was the only recognized treatment. Current therapy is a 4- to 6-week course of antibiotics, such as penicillin G, clindamycin, or metronidazole, directed against F necrophorum. The use of anticoagulation is still controversial.
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From Pronouncement to Partnership: Understanding New Modes of Communication in a Changing Healthcare SystemThe dramatic change in healthcare delivery from private practitioner-based to managed care created a vacuum of responsibility for self care that the patient has needed to fill.
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Study Suggests Correlation Between Atopic Dermatitis and Serum Clusterin LevelsResearchers have reported that higher serum clusterin levels in children may be linked with atopic dermatitis symptom, potentially providing a candidate molecule to reflect disease’s severity.
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The Academy: March 2007The Academy delivers the latest news on biotech and oncology research, providing a link between the clinical world of cancer care and the university researchers who are pushing the envelope of knowledge and discovery. In this issue: 1) University of California, San Diego (UCSD)/Salk Institute for Biological Studies/La Jolla Institute for Allergy and Immunology 2) University of Michigan's Comprehensive Cancer Center/Stanford University School of Medicine 3) University of Rochester 4) Yale School of Medicine 5) University of Illinois at Chicago
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Q&A: The Evolving Treatment Landscape of HyperkalemiaRandy Lieberman, MD, the director of electrophysiology at the Detroit Medical Center, discusses the nature of treating hyperkalemia, and the future plans to improve the landscape for physicians.
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Procainamide-induced Pleural and Pericardial EffusionsDrug-induced diseases and serious adverse drug effects can alter therapeutic plans and greatly affect patient outcomes. Many medications are known to have a narrow therapeutic index and to require close patient monitoring.
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Nonadherence to cardiac medications: An important considerationIn a well-done recent study, Dr P. Michael Ho and colleagues confirm previous data and clinical observations that many patients are nonadherent to their cardiac medications, and, importantly, this nonadherence adversely impacts outcomes, including cardiovascular mortality.
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George Yohrling of the HDSA Encourages Rare Disease AwarenessGeorge Yohrling, Ph.D., Senior Director of Mission and Science at the HDSA discusses the challenges that come with working with patients with HD, and communicating with their family members and caregivers.
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Hepatitis C Genotype Makes a Difference in Liver Disease, Study ShowsPatients with hepatitis C genotype 3 may face more liver problems.
