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How do cardiac and noncardiac conditions affect survival after ICD implantation?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.
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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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Clinical Trial Disparities: A Case for DiversityThe 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.
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Using Telepsychiatry With High-Risk Patients in Rural New York StateTelepsychiatry shown to be viable alternative in rural areas with limited access.
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Developing New Tools to Assess the Impact of Familial Chylomicronemia SyndromeThe development of new tools to quantify the many ways that rare diseases like FCS can affect patients is imperative.
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Mortality of patients with diabetes mellitus and acute myocardial infarctionWe evaluated trends in the treatment and mortality of patients with and without diabetes mellitus and acute myocardial infarction over the last decade. Despite improvements in the provision of evidence-based care, patients with diabetes did not derive improvements in long-term survival.
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Stress echocardiography in diabetes mellitusWe assessed how well dobutamine stress echocardiography predicted morbidity and mortality in 2349 patients with diabetes mellitus over a follow-up period of 13.2 years. Results showed that age, failure to achieve the target heart rate, and the percentage of ischemic segments were independent predictors of both mortality and cardiovascular morbidity. Using clinical and stress echocardiographic parameters, a simple model for risk stratification was developed.
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Pediatric MDS Update with Dr. Inga Hofmann ZhangDr. Inga Hofman Zhang from the University of Wisconsin School of Medicine provides an update on treating MDS in children.
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Sex-related differences in treatment and outcome in patients with ACSThe AMIS (Acute Myocardial Infarction in Switzerland) Plus prospective cohort study compared treatment and in-hospital outcomes between men and women with acute coronary syndrome (N = 26,452) admitted to Swiss hospitals between 1997 and 2007. The study reached several important conclusions: women had different baseline characteristics than men at admission, were treated with different drug regimens, and were significantly less likely to undergo percutaneous coronary intervention. After adjusting for these differences, researchers found no significant difference in the rates of in-hospital mortality between men and women, except for women aged 51 to 60 years, who were more likely to die in-hospital.
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Nonfasting triglycerides and ischemic heart disease in men and womenTriglyceride levels are usually measured after the patient has fasted, and then exclude remnant lipoproteins. Except for the first few hours of the morning, individuals are usually in a nonfasting state for most of the day. We investigated whether nonfasting triglyceride levels predicted the risk of myocardial infarction (MI), ischemic heart disease, and death in the general population. Results showed that increased nonfasting triglyceride levels were associated with an increased risk of MI, ischemic heart disease, and death.
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Early invasive or selective invasive strategies for ACS patientsTreatment of stable patients with acute coronary syndrome (ACS) is controversial. Until recently, large randomized clinical trials had indicated that an "early" invasive strategy with routine cardiac catheterization reduced the likelihood of recurrent cardiovascular events when compared with a more "selective" approach, in which stable patients were referred to cardiac catheterization based on high-risk features on noninvasive stress imaging or because of a failure in initial medical therapy.
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Changes in the Diagnostic Process of Alzheimer Disease: A New Era of Blood-Based ApproachesWhile specialists still debate the diagnostics of impaired cognition, the identification of patients at the earliest stages is beginning to be met through new biomarkers and available assays.
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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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Intermittent inotropic therapy: A clinician's opinionCan any physician consider using intermittent inotropic therapy in patients with congestive heart failure?
