Marian C. Limacher, MD


Women and acute coronary syndromes

Drs Pfeifer and Steingart (page 11) provide a timely report on recent findings affecting the assessment and treatment of women with acute coronary syndromes.

Pamela C. Spigelmyer, PhD, RN, CNS, BSN


Don't Forget to Assess the Family Caregiver of Your Older Adult Patient

Unlike assessments of pediatric patients, healthcare providers do not routinely include the family members or friends in the assessment of older adults—but they should.

Mohammad Dalabih, MD


Nighttime Intensivists: A Question of Whether More Is Better

A number of studies have shown that either a "high-intensity" intensive care unit (ICU), in which all ICU patients are cared for by an intensivist, or one in which an intensivist team consult is mandatory, improves outcomes in the ICU. But does the presence of an intensivist in the ICU around the clock improve outcomes?

Joshua Kahane, MS IV


Financial Incentives for Smoking Cessation in Pregnancy

This is a randomized controlled study of 612 pregnant smokers of a low-income, inner city population in the west of Scotland, United Kingdom.

Lisa Bernardo, RN, PhD


6 Questions with... Lisa Bernardo, RN, PhD, University of Pittsburg School of Nursing

We spoke with Lisa Bernardo, RN, PhD, associate professor at the University of Pittsburgh School of Nursing, to learn about the research study she is leading, �The Effect of a Continuing Education Program on Oncology Nurses� Knowledge of and Confidence in Recommending Exercise to Women with Breast Cancer.� She also provided some recommendations for our readers who may be planning to design their own research studies.

James S. Lacy, JD


The High Cost of Undercoding

Is your practice losing thousands of dollars each month by being too cautious with coding and billing?

Rudrani Banik, MD


Neuro-Ophthalmic Emergencies: Three Diagnoses Not to Be Missed in Primary Care

Neuro-ophthalmic symptoms and signs are the key to diagnosing certain systemic conditions that are considered true emergencies, such as giant cell arteritis, increased intracranial pressure with papilledema, and acute third cranial nerve palsy secondary to intracranial aneurysm. These symptoms and signs may be first encountered by the primary care or emergency department physician; it is critical that they be recognized immediately upon presentation to facilitate expeditious management, which in some cases will save patients' lives and vision.

Leo Rozmaryn, MD


Overcoming Physician Burnout During the Winter

A longtime orthopedic surgeon shares simple habits a physician can adopt to overcome burnout symptoms.

Sripal Bangalore, MD, MHA ? Julien Dreyfus, MS ? Franz H. Messerli, MD


Dangers of aggressively lowering blood pressure in coronary artery disease

We assessed whether there is a paradoxical increase in cardiovascular events with lower blood pressure values among patients with hypertension and coronary artery disease (CAD) who were enrolled in the International Verapamil-Trandolapril Study (INVEST). The relationship between systolic and diastolic pressure and the risk of primary outcome followed a J-curve pattern, with the relationship being relatively weak for systolic pressure but more significant for diastolic pressure. Our data indicate that excessive lowering of diastolic pressure in hypertensive patients with CAD should be avoided.

J. Roberto Duran III, MD


Aspirin Therapy for Prevention of Cardiovascular Disease in Patients with Diabetes

Coronary artery disease is the leading cause of death in patients with diabetes. Platelets play a major role in the pathophysiology and clinical manifestations of ischemic heart disease. It is well known that platelets in diabetic patients are hyperreactive, with exaggerated adhesion, aggregation, and thrombin generation. Aspirin and other antiplatelet agents have been shown to reduce the incidence of ischemic events in patients with and without diabetes, whether or not they have a history of cardiovascular disease. This article reviews the latest recommendations for the use of antiplatelet therapy in the primary and secondary prevention of cardiovascular events in diabetic patients.

Peter Zimetbaum, MD1: From the 1Division of Cardiology, Beth Israel Deaconess Medical Center, Boston, MA


Amiodarone use and permanent pacing for atrial fibrillation: Are there differences between the sexes?

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.

Healthy Body Healthy Mind


Hyponatremia: A Serious Sodium Deficiency

Dr. Verbalis, Dr. Green, and Dr. Miller explain the effects of hyponatremia and Marilyn Getty describes her experience with the condition.

Nico R. A. Mollet, MD


High-resolution spiral computed tomography coronary angiography

We evaluated the performance of the 64-slice spiral computed tomography coronary angiography scanner in 52 symptomatic patients with stable sinus rhythm and found that it was highly reliable in ruling out the presence of a significant coronary stenosis. This technique may be regarded as a suitable alternative to invasive coronary angiography.

Jeffrey W. Stevens MD, PhD


Is circulating heat shock protein 60 a marker for susceptibility to cardiovascular disease in patients with diabetes?

The vital cell stress protein, heat shock protein (Hsp)60, has recently been found in the circulation of healthy subjects over an extremely large concentration range. We performed an analysis of subjects with diabetes to determine whether Hsp60 is associated with biochemical markers of cardiovascular disease. Results showed that high circulating levels of Hsp60 are associated with clinically manifest cardiovascular disease. Hsp60 has cytokine-like actions, which may be responsible for this association.

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