Cardiology

Prompted by almost-epidemic rates of diabetes in the United States and globally, the American Diabetes Association recently convened a consensus panel to examine diabetic kidney disease, one of the most frequent complications associated with diabetes.

Type 2 diabetes occurs at roughly the same prevalence in men and women. Despite the similar prevalence in the sexes, women who develop diabetes feel the effect of its complications disproportionately.

Analysis of a dozen phase III trials indicates that patients with atrial fibrillation face significantly less risk of major, fatal, and intracranial bleeding if they take target-specific oral anticoagulants rather than vitamin K antagonists.

Calculation and interpretation of the anion gap is extremely useful in the evaluation and treatment of the patient with metabolic acidosis. In this installment, we look at case examples involving patients with multiple sclerosis and urosepsis; COPD, diabetes, and renal failure; and type 1 diabetes.

Study results show that patients suffering from active inflammatory bowel disease (IBD) are at risk for poor prognoses following an initial myocardial infarction.

Could portable perfusion devices be a game-changer for organ transplants? The machines keep organs "alive" for days at warm temperatures. That prolongs cell life, slowing the race against the damage that can set in within hours when donor organs are kept on ice in coolers. Manufacturer TransMedics, based in Andover, MA, makes devices for the lung, heart, and liver Researchers and clinicians express growing excitement-along with some skepticism-at the prospect that these medical devices could dramatically increase the viability of donor organs.

News from the literature on a possible link between atherosclerosis and psoriasis and quality of life for patients with this skin condition.

The American Association for Thoracic Surgery (AATS) has released new guidelines designed to prevent the occurrence of atrial fibrillation (AF) in thousands of patients who undergo lung surgery in the United States each year.

Readmission rates among cardiac surgery patients have been reported to range from approximately 14 percent to 63 percent, a rate that far exceeds that in patients who undergo other surgical procedures.

According to the Foundation for Quality Health Care, overall mortality rates associated with coronary artery bypass grafting (CABG) hover at or below 2 percent, a 27 percent decrease from as recently as 2002.

The days of sitting in front of the television with an Atari controller or driving Mario around on his cart are largely over but even the more interactive video games do not do enough to keep this generation of children healthy.

The US Food and Drug Administration (FDA) has approved a new angioplasty balloon catheter for the treatment of vascular disease. The Lutonix 035 Drug Coated Balloon Percutaneous Transluminal Angioplasty Catheter is the first drug-coated balloon approved for use to re-open arteries in the thigh and knee when those arteries are narrowed as a result of peripheral artery disease, the agency said.

Harry Agis, MD, is a vascular surgeon and a partner in the New Jersey Vein Institute, Morristown, NJ. He speaks with Internal Medicine World Report Editor-in-Chief, Simon Douglas Murray, MD about the utility of the ankle-brachial index (ABI) in screening for peripheral artery disease and atherosclerosis and then will touch briefly on a few other subjects that might be relevant to internists with regards to vascular surgery.

Heart trouble can start early for obese children, a German research team found. Writing in the Journal of the American College of Cardiology, Norman Manger, MD, and colleagues compared blood pressure, low-density lipoprotein cholesterol, and glucose metabolism in 61 obese children with that of 40 children with healthy weights. The obese group had an average BMI of about 31 while the control group's average BMI was about 20.

In women with aortic stenosis (AS) survival is linked to whether resulting left ventricular hypertrophy (LVH) is adaptive or maladaptive. In men with AS, there is no such link, a German study found.

Study results show that the majority of adult patients with congenital heart disease and their clinicians ignore American College of Cardiology and American Heart Association recommendations that any non-cardiac surgery for these patients should be performed in regionalized centers of expertise.

A recommendation by two FDA advisory panels to narrow the official approval for testosterone replacement therapy has won generally favorable reviews from medical organizations, although questions remain about its ultimate impact.

A team of researchers at the University of Cambridge recently announced findings from a study that showed there is likely no link between a person's vitamin D levels and their risk of developing type 2 diabetes.

For patients with heterozygous familial hypercholesterolemia, statin therapy is often not enough to reduce LDL cholesterol. In two articles in The Lancet, researchers report on promising results of two international Phase 3 trials of evolocumab. The drug is a monoclonal antibody to proprotein convertase sudbtilism/kexin type 9 (PCSK9).

Research from Denmark finds that people with diabetes are nearly twice as likely as non-diabetic people to develop atrial fibrillation.

A study published in the Journal of the American Medical Association found hospitals' administration of pharmacologic venous thromboembolism (VTE) prophylaxis was not associated with lower rates of VTE.

For individuals with hypercholesterolemia, research published in the Journal of American Medical Association provided recommendations on statin use for treating their condition prior to age 80.

For individuals without diabetes, hemoglobin A1c (HbA1c) levels not only predicted the prevalence of coronary artery disease (CAD), but also anticipated its severity, according to research published in Mayo Clinic Proceedings.

Device therapy eligibility requirements are underestimated using 2D echocardiography compared to cardiac magnetic resonance imaging, according to a study from the Netherlands Heart Journal.

Resistant hypertension is common among patients with type 2 diabetes, and is strongly associated with microvascular disease.

In this installment, we look at underlying causes of metabolic acidosis, approaches for evaluating patients with suspected metabolic acidosis, and why measurement of the anion gap is of great usefulness in these cases.

New research suggests that low testosterone levels may indicate that men face a greater risk of sudden cardiac arrest.

As more practices and hospitals enter the digital age with Electronic Health Records (EHR) and other health information technology tools, a recent article points out that all those efforts are only half the battle.

Implementation of Massachusetts health care reform reduced all-cause mortality and mortality from causes amenable to health care

Efficacy of anti-inflammatory or antibiotic treatment in patients with non-complicated acute bronchitis and discoloured sputum: randomised placebo controlled trial