Among patients with atrial fibrillation, amiodarone (Cordarone, Pacerone) is the most useful drug for the preservation of sinus rhythm.1-3 Although amiodarone carries a well-known risk of potentially serious noncardiac toxicities, perhaps less well recognized is its major cardiovascular side effect of bradycardia.
Medication adherence rates struggle in many conditions and diabetes is among the worst of them. Michael Greenfield, MD, discusses 3 ways for clinicians to improve adherence.
How to use all of your medical gadgets without forgetting about the patient in the room.
Conventional measurements of cardiac lipoprotein risk include cholesterol, triglyceride, and high-density lipoprotein (HDL) cholesterol levels. Low-density lipoprotein (LDL) cholesterol is estimated from these measurements.
It has been legal to transmit prescriptions for federally designated controlled substances electronically since June 2010. Yet, few of the physicians who already have embraced electronic prescribing have been able to take advantage of the change in the law.
Only 2 cases of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) pericarditis have been reported in the English literature. Over the last 15 years, CA-MRSA has emerged as an increasingly common pathogen that is genetically and epidemiologically different from hospital-acquired MRSA (HA-MRSA).
We assessed the relationship between high-density lipoprotein (HDL) cholesterol level and carotid plaque progression in 1952 men and women with preexisting carotid atherosclerosis over a period of 7 years. The HDL cholesterol level was inversely related to plaque growth. The plaques that became more echogenic during follow-up had a lower growth rate compared with those that became more echolucent. These findings suggest that HDL cholesterol stabilizes plaques and counteracts their growth by reducing their lipid content and inflammation.
We 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.
The effects of recurrent tachycardia after resolution of cardiomyopathy have not been thoroughly assessed. We evaluated and followed 24 patients with tachycardia-induced cardiomyopathy for more than 12 years. Our observations showed that patients with tachycardia-induced cardiomyopathy may be at long-term risk for sudden death. Surreptitious cardiomyopathy due to occult ultrastructural changes may persist. It has yet to be determined whether rapid and aggressive rate control would prevent structural damage to risk of sudden cardiac death.
Reduced exercise capacity is associated with an increased risk of myocardial infarction, unstable angina, and coronary revascularization in patients referred for exercise treadmill testing for clinical indications.
The benefits of implantable cardioverter-defibrillators (ICDs) have been shown in randomized clinical trials. The factors that affect the risk–benefit ratio in a community setting, however, have not been evaluated.
The purpose of this Priority Report is to raise awareness of metastatic breast cancer.
A prenuptial agreement is the hard, clear-eyed antithesis of the rosy optimism newlyweds bring to the altar.
Treatment regimens comprised of DCV+SOF±RBV and VEL/SOF+RBV offer similar cure rates among HCV patients with genotypes 2 and 3.
The benefits of implantable cardioverter-defibrillators (ICDs) have been shown in randomized clinical trials. The factors that affect the risk–benefit ratio in a community setting, however, have not been evaluated.
Carcinoids 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.
The challenge of eliminating disparities in clinical trials is being addressed by the Eliminating Disparities in Clinical Trials (EDICT) project, which recognizes that broadening diversity in clinical trials will result in improved effectiveness and safety of future medicines, improved trial quality, and reduced discrepancies in health equity.