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Managing Obesity Through Pharmacology

Obesity contributes to significant morbidity and mortality among primary care patients. This paper summarizes options for pharmacological management of obesity. Medications approved for obesity are Phenteremine/Topiramate, Orlistat, Lorcaserin, Naltrexone/Bupropion, Liraglutide.

Eat Fiber: One Simple Message for Weight Loss

This study was a randomized, controlled trial of 240 adults with metabolic syndrome who were assigned to follow either the single-component dietary recommendation of increased fiber consumption (≥30g/d), or the multi-component American Heart Association (AHA) dietary guidelines. The primary outcome measure was weight loss at 12 months.

Folding@home: How Distributed Computing Is Unraveling the Mysteries of Protein Folding

In October 2000, a team of researchers at Stanford University led by Vijay Pande, PhD, debuted a distributed computing project designed to simulate the protein folding process.

An Open Letter to the Woman at the Supermarket

A little small talk in the produce section illustrates the challenges of small-town doctoring.

Tax Credits and Deductions for Physicians

Combine Business with Pleasure and Save

Comprehensive lifestyle modification and blood pressure control

Lifestyle recommendations for the prevention and treatment of hypertension include weight loss, reduced sodium intake, increased physical activity, limited alcohol intake, and the Dietary Approaches to Stop Hypertension (DASH) diet. The 18-month results of the Prospective Registry Evaluating Myocardial Infarction: Events and Recovery (PREMIER) randomized clinical trial showed that individuals with prehypertension and stage 1 hypertension can make and sustain many of these lifestyle changes over the long term, thereby reducing their risk of cardiovascular disease.

Never too old for statins

Elderly patients with a history of an acute coronary syndrome (ACS) are at higher risk for subsequent cardiovascular events than younger patients.

Predicting survival in elderly patients with heart failure

Over a period of 14 years, we followed 282 patients aged 70 years or older who were hospitalized with heart failure. Median survival was 2.5 years, but 25% of patients died within 1 year, and 25% survived for at least 5 years following hospital discharge. A simple 7-item risk score based on data readily available at the time of hospitalization effectively stratified patients into low-, intermediate-, and high-risk categories for subsequent mortality.

The Risk of Risk: Explaining Difficult Concepts to Patients

A key component of health literacy is the ability to understand statistics and concepts like "probability" and "risk."

Long-term diuretic use and increased mortality and hospitalization in heart failure

Diuretic use has long been a mainstay in the management of symptomatic heart failure with pulmonary or systemic congestion, or both.

Maintaining sinus rhythm after cardioversion of atrial fibrillation

We 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.

Assessing COVID-19 Mortality

Swiss researchers propose a new method to assess COVID-19 mortality.

Acute aortic occlusion: Common presentation of an uncommon catastrophe

There 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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