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Large-scale clinical epidemiology of stable angina in women and menWe performed a whole-country study using linked health care records in Finland and showed that stable angina as the initial symptomatic manifestation of coronary disease occurs as frequently in women as it does in men. Among easily recognized subgroups, the absolute rates of prognostic outcomes were similarly high in women and men.
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Psychiatric Medication as a Warm CoatI'd like to introduce Junig's Warm Coat Theory of Psychotropic Prescribing, or what I suggest the medical field refers to as the "JWCT."
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ARBs and the Impact of Worsening Renal Function in Heart Failure Patients With Preserved EFWorsening renal function over time is associated with poorer outcomes in patients with acute and chronic HF. Although this association is established in patients with reduced ejection fraction, there are no data about the relationship between WRF and outcomes in HF patients with preserved ejection fraction.
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Body mass index and cardiovascular events in patients with hypertension and left ventricular hypertrophyIn a separate analysis of patients enrolled in the Losartan Intervention For Endpoint reduction in hypertension (LIFE) study, thin patients and those with moderate-to-severe obesity were at increased risk for cardiovascular events. These results indicate that patients at the low anda high ends of the body size spectrum should be treated aggressively to lower the risk of cardiovascular events.
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Controversial Changes to Screening Recommendations for Preventive Pediatric CareThe American Academy of Pediatrics designed the 2014 Recommendations for Pediatrics Preventive Health Care to guide well-child care, but there is controversy over some of the changes.
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Lymph Nodes and Breast Cancer? Is Less as Good?How important is a completion node dissection for women with a positive sentinel node biopsy in breast cancer?
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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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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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A misleading ECGA 10-year-old girl was brought to her primary care provider by her mother because she complained of chest pain earlier that morning. She also reported abdominal pain and nausea.
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Overcoming Resistance to Catheter-Directed Therapy in Submassive Pulmonary EmbolismThe optimal treatment of submassive pulmonary embolism (PE) remains controversial, despite growing evidence to support a role for catheter-directed therapy in carefully selected patients.
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Transcatheter occlusion of the left atrial appendage to prevent stroke in atrial fibrillationWe conducted 2 feasibility studies to assess the performance and safety of the percutaneous left atrial appendage (LAA) transcatheter occlusion system for the prevention of stroke in high-risk patients with nonrheumatic atrial fibrillation. Results showed that percutaneous LAA occlusion can be performed using the device at acceptable risk. This procedure may be particularly useful for patients at increased risk of ischemic stroke with a contraindication to anticoagulation therapy.
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Symptomatic carotid plaques and ischemic symptomsWe assessed the histologic features of 526 carotid plaques from consecutive patients undergoing endarterectomy for symptomatic carotid stenosis and found a high prevalence of coronary-type plaque instability, with strong correlations between macrophage infiltration and both cap rupture and time since stroke. Temporal trends were much weaker after a transient ischemic attack than after a stroke, with a tendency for plaque features to persist for a longer period, suggesting heterogeneity in the underlying pathological mechanisms.
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Hydatid Liver Disease in a Patient with Chronic Right Upper-Quadrant Abdominal PainHydatid disease of the liver is endemic in some areas of the world but is rarely encountered in the United States. The disease is usually caused by the parasite Echinococcus granulosus. Physicians who work within multicultural communities must be aware of this disease and its treatment. We present the case of a 35-year-old Mexican woman who complained of chronic right upper-quadrant pain. Computed tomography scanning revealed a ring-enhancing lesion within the right lobe of the liver, suggesting the diagnosis of a hydatid cyst. Following a course of antiparasitic therapy, the cyst was surgically removed. Six months later, the patient was pain free.
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Preventing and Treating Hospital-associated Infections in Elderly PatientsOne important aspect of medical care for the elderly is enacting strategies to prevent infections before and during hospitalization.
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Alogliptin: The newest agent to fight the diabetes pandemicAccording to the American Diabetes Association (ADA), 23.6 million children and adults have diabetes (8% of the US population) and another 5.7 million cases remain undiagnosed. Epidemiologists predict that these statistics will double by 2030, further taxing the healthcare system. Medical expenditures are approximately 2.3 times higher for diabetic versus nondiabetic patients, and the annual cost of diabetes is estimated to be $116 billion.
