June 2015

An Exciting ECG...A Little early?

July 01, 2015

Cardio Corner

A 36-year-old man presents to his primary care physician's office for follow-up after being told he had an abnormal ECG at a health fair he attended. He has no complaints. He is sedentary and does not participate in any exercise or athletic activity.

Antidepressants for Analgesia

July 01, 2015

Pain Perspectives

While treating our patients' depression is a crucial aspect of sound pain management practice in primary care, the analgesic effects of certain antidepressants, particularly for select types of chronic pain, should also not be underestimated.

PCSK9 Inhibitors: Newer Does Not Always Mean Better

July 01, 2015

Editor's Letter

With much fanfare earlier this month, the Endocrinologic and Metabolic Drugs Advisory Committee of the Food and Drug Administration endorsed approval of 2 new highly-anticipated, injectable agents for lowering cholesterol, alirocumab and evolocumab. Although the FDA is not obliged to follow these recommendations, it is a only a matter of time before these two proprotein convertase subtilisin kexin 9 inhibitors will be available by prescription in the United States.

When is Alcohol Consumption Protective?

July 01, 2015

FPR Journal Club

This study evaluated the association between alcohol consumption and all-cause mortality, as well as the relevance of age-specific limits for alcohol consumption. Alcohol use, particularly consumption of excessive amounts, is negatively associated with many acute and chronic diseases. The direct and indirect economic burden due to alcohol use is substantial.

How Would You Manage This Man With Non-alcoholic Fatty Liver Disease

July 01, 2015

Consultant's Corner

You see a 48-year-old white man for his annual examination. He is in good health with no major medical problems and an unremarkable medical history. He states he regularly drinks one or two beers a day on the weekend but not usually on weekdays. He denies blood transfusions, tattoos or intravenous drugs. His father had diabetes. Physical examination is notable for the patient being mildly obese with a body mass index of 32.

Proton Pump Inhibitors Increase CHD Risk

July 01, 2015

FPR Journal Club

There is consistent observational data that identifies concomitant use of proton pump inhibitors for gastroesophageal reflux disease and clopidogrel following acute coronary syndrome increases the risk of recurrent cardiovascular events. While a variety of theories exist (lower pH alters absorption, etc.), no clear factor has been identified.

The Real Risks of Sitting

July 01, 2015

FPR Journal Club

This study was a meta-analysis that examined the association between sedentary behavior and hospitalizations, all-cause mortality, cardiovascular disease, diabetes and cancer in adults.

Taking Another Look at the Link Between Vaccination and Autism

July 01, 2015

FPR Journal Club

This Meta analysis verified that there is no relationship between MMR vaccinations and the development of autism, and found no evidence of publication bias, implying that the medical literature was not altered to hide an association.

How Accurate are Cardiac Risk Calculators?

July 01, 2015

FPR Journal Club

This prospective epidemiological study compares the capabilities of the new 2013 American Heart Association and American College of Cardiology ASCVD risk calculator against several alternative cardiovascular risk calculators and explores the potential effect of preventive therapy on risk overestimation in the AHA-ACC-ASCVD model.