Authors
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Payers and Health 2.0Making sense of the data is paramount to leveraging stakeholders and to make incentives to bring them all together.
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Alcohol and hypertensionTo determine whether alcohol-associated hypertension carries risks similar to those of hypertension in abstainers or light drinkers, we prospectively studied cardiovascular sequelae separately in heavy drinkers, light drinkers, and abstainers. The risk of all outcomes was progressively higher for increasing blood pressure categories, with similar associations in each alcohol category. These data indicate that the risks of hypertension are independent of the amount of alcohol intake.
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Intrauterine System Matches Efficacy of Hysterectomy in MenorrhagiaWhile a variety of surgical procedures can treat menorrhagia in premenopausal women, a recent study added a non-surgical alternative to the mix.
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Sex differences in the development of higher systolic blood pressure during adolescenceWe evaluated the differences in higher systolic blood pressure (SBP) between boys and girls in a longitudinal adolescent cohort. Results showed that although boys have a 19% relative increase in the risk of higher SBP annually between the ages of 13 and 17 years, girls do not experience the same risk increase. Among both boys and girls, being overweight increases the likelihood of high SBP almost 3-fold, and every 5 additional hours of "screen time" (television viewing, video game playing, Internet use) is associated with a 4% relative increase in the likelihood of higher SBP levels. For every 5 additional sports-related or other active behaviors over a 7-day recall, there was an 8% relative reduction in high SBP risk. Annual blood pressure assessment in teens that continues into adulthood may facilitate early detection of adult hypertension. Weight control, increased physical activity, and reduced screen time may reduce the likelihood of higher SBP levels developing in adolescents.
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How Risky Is Driving While Sleepy?Researchers investigated the effects of sleepiness, sleep hygiene, sleep disorders, and driving risk among highway drivers in France.
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Dealing with Treatment Adherence Issues in Acute ConditionsToo often, patients seek help and receive medical advice but return for follow-up with less-than-optimal improvement because they did not comply with recommended therapy. Costs of nonadherence add to the economic burden of health care in the United States and interfere with appropriate treatment. By discussing with the patient anticipated barriers, such as perceived side effects or regimen complexity, the physician can significantly improve outcomes. The authors outline ways to enhance patient compliance and improve the clinical picture while reducing costs.
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Revisiting the silent killer in Asian IndiansWhile reviewing the American Heart Association (AHA) 2008 Clinical Perspectives in the January 2009 issue of Cardiology Review, especially the article by Dr Ferdinand regarding African American beliefs and adherence to antihypertensive medications, it dawned upon me that a review of articles and data on hypertension in Asian Indians is also warranted, as this population is often overlooked.
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Atrial fibrillation, antiarrhythmic drugs, and maintaining sinus rhythmLafuente-Lafuente and colleagues performed a meta-analysis of 44 studies of 11 322 patients in randomized controlled trials of persons with atrial fibrillation who received antiarrhythmic drugs after restoration of sinus rhythm.
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Age-related Macular Degeneration: Clinical Features and Therapeutic OptionsAge-related macular degeneration is the leading cause of irreversible legal blindness in the elderly. Although nothing can reverse the associated vision loss, treatments are available that can slow the rate of progression of this condition. These options include supplemental high-dose vitamin therapy, diet and lifestyle changes, laser photocoagulation, photodynamic therapy, and intravitreal injection of anti-angiogenic medications. Early diagnosis and initiation of appropriate treatment are critical.
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Uncontrolled asthma and Cushing's syndrome: Where does anti-IgE fit in?Steroid treatments are a first-line therapy for asthma but can have considerable side effects, such as Cushing's syndrome. Patients who develop such complications or become intolerant to steroid therapy may be candidates for anti-IgE treatment.
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Newer Anticoagulant Agents Carry Bleeding Risks of Traditional Atrial Fibrillation TreatmentAs newer anticoagulants become accepted into clinical practice, it is important to consider their unique properties, potential benefits, and how they act in the coagulation cascade.
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The Metabolic Syndrome: Pathogenesis, Consequences, and Treatment StrategiesThe last several years have witnessed a heightened interest in the metabolic syndrome, as it has become a health issue of epidemic proportions. Several metabolic abnormalities emerge as key players in the pathogenesis of the syndrome, including insulin resistance, obesity, and inflammation. Individuals with the metabolic syndrome are at increased risk for a variety of clinical conditions, some with serious health implications, particularly diabetes and cardiovascular disease. Treatment should address the causal mediators of the syndrome, such as obesity or insulin resistance. Lifestyle modification is one of the most successful treatments for the prevention of diabetes. Pharmacotherapy for dyslipidemia or hypertension can help prevent cardiovascular complications and the development of diabetes in those at risk.
