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As clinical cardiologists, we face an ever-changing landscape with regard to the management and care of hypertensive patients.

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To evaluate the interactions between the weight loss drug, sibutramine, and different antihypertensive treatments, we randomly assigned 171 subjects taking 3 antihypertensive treatment regimens to receive sibutramine or placebo. Our study showed for the first time that combination therapy with an angiotensin-converting enzyme inhibitor and a calcium channel blocker is more advantageous than a ß blocker/diuretic-based-regimen with regard to supporting the weight-reducing actions and metabolic changes induced by sibutramine.

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Rather than being a force for depersonalizing medicine and driving a wedge between patients and physicians, it turns out that information technology and social media offer new opportunities for deeper communication and interaction.

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Use the negative financial climate to your advantage when choosing a new banking partner. These ten questions will help you determine whether the banks on your short list can handle your needs.

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Many studies have shown higher rates of depressive disorders in women than in men, with a female-to-male ratio of approximately 2:1. We examined gender characteristics in a jail setting to test the hypothesis that depression is much more common in men than has previously been reported. This setting provided a unique opportunity to diagnose and treat men with depressive disorders who would be less likely to be diagnosed with depression outside prison.

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Recent studies suggest a link between ADHD and alcoholism.

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The HIV Medicine Association, the American Academy of HIV Medicine, The Association of Nurses in AIDS Care and the Ryan White Medical Providers Coalition have written to US Senators urging them not to repeal the Affordable Care Act.

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What happens to your practice when you are out of the office? This is of particular relevance to solo practitioners.

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We examined the prevalence and risks associated with undiagnosed diabetes mellitus among more than 7000 patients who had undergone coronary artery bypass graft surgery. At the perioperative and postoperative stages, patients with undiagnosed diabetes showed a significantly higher morbidity and mortality rate.

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Clinicians should consider a patient's risk of hypoglycemia, the duration of time with the disease, age, comorbidities, vascular complications, and other factors when setting treatment goals.

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Carcinoids 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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The initial capital outlay for transitioning to an EHR is not small. In fact, cost is one of the main reasons practices have been slow to adopt EHRs.

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Responding to the public's demand to seek redress for injuries, real or imagined, at the hands of physicians, the established forces of organized medicine have turned inward in an attempt to better police their members. Out of these good intentions came the QA departments, to be found now in every hospital, HMO, and clinic. Their mandate is to weigh accusations, often brought secretly; investigate, often done selectively; deliberate, often done behind closed doors; and sentence, often without chance of appeal.

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The vaccines did not result in reductions in semen volume, sperm concentration, sperm motility, and total motile sperm count.

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We found sex differences in the pattern of relative strength when riskfactor associations with death from cardiovascular disease (CVD) were evaluated across different periods of follow-up. In women, an increased risk in CVD-related death was associated with diabetes mellitus and smoking; this risk was most prominent in the early follow-up period. Our finding illustrates that clinicians should employ more intense preventive measures in women who are smokers or have diabetes.

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We examined the prevalence and risks associated with undiagnosed diabetes mellitus among more than 7000 patients who had undergone coronary artery bypass graft surgery. At the perioperative and postoperative stages, patients with undiagnosed diabetes showed a significantly higher morbidity and mortality rate.

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Pheochromocytoma is a rare chromaffin cell neoplasm that secretes catecholamines and is usually found in the adrenal medulla. One fourth of these tumors are the result of genetic inheritance. Hypertension is the most common symptom. The classic triad of paroxysmal symptoms?consisting of palpitations, diaphoresis, and headaches?should prompt a consideration of this diagnosis and appropriate laboratory testing. The best biochemical marker is plasma free metanephrines, which is 99% sensitive and 89% specific for diagnosis. Magnetic resonance imaging and radioactive iodine metaiodobenzylguanidine scans are used to localize the tumor before surgery.

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Consider this hypothetical situation: A patient with new onset of a major depression is evaluated by a physician who has found no evidence of suicidal ideation.

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We 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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Lemierre's syndrome is characterized by oropharyngeal infection, usually by Fusobacterium necrophorum, followed by septic thrombophlebitis of the internal jugular vein with embolization to the lungs and other organs. Since the introduction of antibiotics, Lemierre's syndrome has become relatively rare and is usually unsuspected until blood culture results are available. In the preantibiotic era, ligation of the internal jugular vein on the affected side to prevent septicemia was the only recognized treatment. Current therapy is a 4- to 6-week course of antibiotics, such as penicillin G, clindamycin, or metronidazole, directed against F necrophorum. The use of anticoagulation is still controversial.

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The dramatic change in healthcare delivery from private practitioner-based to managed care created a vacuum of responsibility for self care that the patient has needed to fill.

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Researchers have reported that higher serum clusterin levels in children may be linked with atopic dermatitis symptom, potentially providing a candidate molecule to reflect disease’s severity.

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The Academy delivers the latest news on biotech and oncology research, providing a link between the clinical world of cancer care and the university researchers who are pushing the envelope of knowledge and discovery. In this issue: 1) University of California, San Diego (UCSD)/Salk Institute for Biological Studies/La Jolla Institute for Allergy and Immunology 2) University of Michigan's Comprehensive Cancer Center/Stanford University School of Medicine 3) University of Rochester 4) Yale School of Medicine 5) University of Illinois at Chicago