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Does Race Impact Mortality Rates in Patients with End-stage Renal Disease?During a press conference at Kidney Week 2011, Sandra Amaral, MD, MHS, Children's Hospital of Philadelphia, stressed how important it is for pediatricians and pediatric nephrologists to promote the process of kidney transplant to happen as soon as possible in children who are diagnosed with ESRD.
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Let's Get Smart about Antibiotic PrescribingAntibiotics are commonly prescribed by a wide range of clinicians. Data suggest that up to 50% of prescribed antibiotics are "unnecessary" or "inappropriate".
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Integrating the existing emergency medical system with automated external defibrillators for out-of-hospital cardiac arrestWe investigated whether a program based on diffuse deployment of automated external defibrillators operated by trained volunteers and laypersons across the largest county in Italy would safely and effectively improve the current survival rate among patients with out-of-hospital cardiac arrest. Compared with historical control subjects, the new strategy resulted in a 3-fold increase in 1-year survival free of neurologic impairment.
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Who Can Sign Your Checks?Whether you are incorporated or are sole proprietor, your spouse should be signatory to your business checking account.
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Estate Planning Essentials for PhysiciansPlanning can dramatically reduce-or avoid altogether-some common tax hits, including: capital gains, state, inheritance, and estate and gift taxes. There are several options to consider when building an estate plan.
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Procainamide-induced Pleural and Pericardial EffusionsDrug-induced diseases and serious adverse drug effects can alter therapeutic plans and greatly affect patient outcomes. Many medications are known to have a narrow therapeutic index and to require close patient monitoring.
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Noninvasive coronary angiography with multislice computed tomography and myocardial perfusion imagingA total of 114 patients with an intermediate pretest likelihood of coronary artery disease were evaluated with both multislice computed tomography (MSCT) and myocardial perfusion imaging (MPI). Results showed that in the majority of cases, a normal MSCT scan was associated with normal perfusion. However, only half of patients with significant stenoses showed abnormal perfusion. Accordingly, MPI and MSCT are intrinsically different techniques and appear to be complementary rather than overlapping as they provide information on atherosclerosis versus ischemia, respectively.
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Why do Women Have Trouble Taking Their Prenatal Vitamins?Tips for maximizing compliance based on 40 years of experience, and a new policy decision which could make matters worse.
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Intensive statin therapy in acute coronary syndromeWe conducted a meta-analysis of 13 randomized controlled trials involving 17 963 subjects to determine the effect of intensive statin therapy instituted within 14 days of hospitalization for acute coronary syndrome. Results showed that early, intensive statin therapy is safe and significantly decreases cardiovascular death and recurrent ischemia following acute coronary syndrome after 6 months of treatment.
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Are Flawed Dose Conversion Calculators to Blame for the Dramatic Increase in the Number of Methadone Overdoses?Although methadone accounts for only 2% of opioid prescriptions, it caused nearly one in 3 prescription opioid overdose deaths in 2012, a 6-fold increase from 2009, according to the CDC.
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The Benefits of Fish Oil and Peanut Butter in Newborns, ChildrenWhile peanut butter exposure aids children from an early age, fish oil could improve asthma rates.
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Case-Based Peer Perspectives in Fabry DiseaseDawn Laney, MS, CGC, CCRC, Assistant Professor and Director, Emory Genetic Clinical Trials Center, talks misdiagnosis in Fabry disease through a case study.
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Screening routines for coronary anomaliesThe case report by Gandhi and Rosenberg illustrates some of the concerns regarding coronary anomalies.
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Comprehensive lifestyle modification and blood pressure controlLifestyle 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.
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Ultrafiltration for heart failureWe compared the use of early, minimally invasive ultrafiltration with usual care in patients with acute decompensated heart failure in a randomized controlled trial. Ultrafiltration therapy resulted in greater fluid removal than standard therapy and was shown to be a safe and effective alternative to loop diuretics for sodium and fluid homeostasis in patients with heart failure. More research is needed to identify those patients most likely to benefit from this approach.
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Improving Blood ManagementIn this feature article, Ajay Kumar, MD, discusses how the Cleveland Clinic is leveraging technology to refine the use of blood components.
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Extreme lipoprotein(a) levels and myocardial infarctionWe conducted a study to determine whether high lipoprotein(a) levels predicted the risk of myocardial infarction (MI) and ischemic heart disease. Unlike other studies, we measured lipoprotein(a) levels shortly after sampling and corrected for regression dilution bias.
