• Rest in Peace

    Updated: 2011-04-28 23:10:31
    One of the unique realities of being a physician is the integration of your life with others.  At times that integration is quite close as you come to know patients over a lengthy period of their life.  I may be part of the last generation of physicians who have this opportunity as the practice of [...]

  • A sign of the times…Everyone says sleep longer

    Updated: 2011-04-26 20:26:19
    As far back as Benjamin Franklin, sleep has been a topic of interest.  You will remember that Franklin — who published Poor Richard’s Almanac — said, “Early to bed and early to rise makes a man healthy, wealthy and wise.”  Interesting that Franklin said healthy first.  There is a growing body of research that seems [...]

  • How far increasing hdl can protect your heart

    Updated: 2011-04-26 17:44:20
    Increase Hdl Lower Ldl Hdl Ldl Ratio High Cholesterol Atheroslerosis Low fat Subscribe To This Site About increasing hdl cholesterol How far increasing hdl can protect your heart What are the alternative to increase hdl cholesterol When raising hdl , at the same time you are cutting your chances to develop heart disease . Keep in mind that hdl good cholesterol is that type of lipoprotein , which carries the excessive cholesterol out of your . body It can scrub your blood vessels from the extra cholesterol . And you will not have any more hard and thick blood vessels . And of course you will be safe from any heart disease . If you perform a lipid profile , you must look for the levels of hdl higher than 60 mg dl . This can make you sure that you are protected from any heart disease . If

  • Blood-pressure deaths down—but not far enough

    Updated: 2011-04-25 22:01:00
    First, the good news: premature deaths from high blood pressure are down compared with 20 years ago, according to a new report from the Centers for Disease Control and Prevention (CDC). And now the bad: People with high blood pressure...

  • What’s the true cost of Pradaxa?

    Updated: 2011-04-21 22:53:37
    At the recent American College of Cardiology meeting in New Orleans, an analysis was done on the patients who were studied in two trials: the RE-LY and the RECOVER.  The RE-LY study or Randomized Evaluation of Long-Term Anticoagulation Therapy was the trial that enrolled 18,000 patients and served as the pivotal study which the FDA [...]

  • Yawn. The American College of Cardiology meeting and why we are in trouble

    Updated: 2011-04-19 21:04:35
    Early this month, the American College of Cardiology meeting was held in New Orleans.  I am here to tell you that nothing new was presented.  As discussed in my blog posts, one of the things that has been shipped overseas is research, so most studies are now presented at the European Society of Cardiology meeting.  [...]

  • Frusemide strategies in heart failure

    Updated: 2011-04-14 21:30:48
    While loop diuretics are an acknowledged component of therapy for patients with acute decompensated heart failure, as they were introduced into clinical practice prior to the era of large randomised controlled trials there are few prospective data to guide their use. To better define the most pertinent strategy for their use, the authors conducted a prospective, [...]

  • ARB not found to benefit AF

    Updated: 2011-04-14 21:19:20
    Whilst reducing blood pressure reduces the risk of heart failure and stroke this relationship has thus far not been demonstrated in patients with atrial fibrillation.  This is despite the fact that recent mechanistic work and retrospective analyses have suggested that both ACE inhibitors and ARBs have specific properties that alter atrial mechanical and electrical remodelling [...]

  • Who decides what’s “appropriate” (Part 3)

    Updated: 2011-04-14 20:56:10
    In my previous blogs, I have attempted to provide a brief overview of the process and reasons why Appropriate Usage Criteria (AUC) has been developed.  One paper published last week and one study presented last week at the American College of Cardiology meeting in New Orleans again highlight the problems we as physicians face in [...]

  • Catherine Zeta-Jones: What’s bipolar disorder II?

    Updated: 2011-04-14 18:31:18
    With the news that Catherine Zeta Jones is undergoing treatment for bipolar disorder II, most people are probably wondering what it is. Bipolar disorder II is often described as a milder form of bipolar disorder, in which the patient usually experiences depression and may live an otherwise normal life, when they’re not in the throes of a manic [...]

  • Free head- and neck-cancer screening in Winter Park

    Updated: 2011-04-14 16:55:38
    After actor Michael Douglas revealed that he was suffering from throat cancer, a lot of Americans wondered about their chances of developing throat cancer. Now the head and neck cancer specialists at Florida Hospital are offering free screenings to the public. On Tuesday, April 26, they will conduct free screenings from 2:30 to 4:30 p.m. at the YMCA Crosby Wellness Center, 2005 Mizell Ave. [...]

  • Who decides what’s “appropriate?” (Part 2)

    Updated: 2011-04-12 17:15:20
    Almost a decade ago, the Rand Corporation was interested in healthcare, and they developed a way to achieve consensus documents.  The participants provide numerical assessments and then try to move to “the middle” and achieve a document which satisfies everyone (this is usually followed by joining hands and singing Kumbaya).  Sometimes when endpoints are fixed [...]

  • Metformin May Work Better Than Other Drugs in Preventing Death: Study

    Updated: 2011-04-12 15:51:01
    Patients who take the diabetes drug metformin may be less likely to die over the course of 10 years than patients who take insulin secretagogues, a new study has found.

  • 2-year RESOLUTE data emphasise need for secondary prevention

    Updated: 2011-04-05 22:27:15
    The RESOLUTE All Comers trial showed that the Resolute zotarolimus-eluting stent was non-inferior to the Xience V everolimus eluting stent in terms of target lesion failure (revascularisation, myocardial infarction, or cardiac death).  However, long-term follow-up data from drug-eluting stent trials are generally scarce.  Silber et al. report the 2-year clinical outcomes from the original RESOLUTE [...]

  • Maybe it really doesn’t matter (Part 3): How the trigger was pulled on Gravitas

    Updated: 2011-04-05 20:20:38
    I have been going over the strange yet wonderful story of Plavix which to put it another way is an example of I’d rather be lucky than smart.  For sometime now, we as physicians have been inundated with material about how we should prevent stent thrombosis.  Studies have been started and published.  First go one [...]

  • Does physical activity trigger cardiac events?

    Updated: 2011-04-04 18:26:35
    Physical activity conveys many health benefits including a reduction in the chances of developing cardiovascular disease.  However, it has also been suggested that physical activity, as well as others acute exposures such as sexual activity and psychological stress, can actually trigger acute cardiac events. Dahabreh and Paulus performed a meta-analysis of 14 studies (10 investigating episodic [...]

  • Novel diagnostic pathway improves chest pain assessment

    Updated: 2011-04-04 12:25:24
    Although 75-85% of patients presenting to the emergency department with chest pain ultimately do not receive a diagnosis of acute coronary syndrome, a lengthy assessment process is still mandatory as patients with a missed diagnosis of myocardial infarction are at increased risk for a cardiovascular event.  Than et al. prospectively validated the safety of a [...]

  • Antidepressants linked to thicker arteries

    Updated: 2011-04-03 16:31:24
    Antidepressant use has been associated with thicker arteries, possibly contributing to the risk of heart disease and stroke, in a study of twin veterans. The data is being presented Tuesday, April 5 at the American College of Cardiology meeting in New Orleans. Depression can heighten the risk for heart disease, but the effect of antidepressant use revealed by the study is separate and independent from depression itself, says first author Amit Shah, MD, a cardiology fellow at Emory University School of Medicine. The data suggest that antidepressants may combine with depression for a negative effect on blood vessels, he says. Shah is a researcher working with Viola Vaccarino, MD, PhD, chair of the Department of Epidemiology at Emory's Rollins School of Public Health........

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