Mitral Valve Surgery in the Elderly Less Risky Than Previously Reported
Cardiology Summary and Comment
Patient age alone should neither preclude surgical treatment nor deter consideration of repair rather than replacement.
By Howard C. Herrmann, MD
May 1, 2013
Covering:
Vassileva CM et al., Circulation 2013 Apr 8
Rao RK and Foster E., Circulation 2013 Apr 8
Dementia Outpaces Cancer in Financial Burden to United States
Neurology Summary and Comment
A model that includes costs of informal care estimates that more than US$150 billion was spent in 2010.
Treating Apathy After Aggressive Medication Reduction Following DBS for Parkinson Disease
Neurology Summary and Comment
A trial of piribedil to treat apathy after deep brain stimulation for PD has implications for post-surgical care.
Predicting Medication Response in Older Depressed Patients
Psychiatry Summary and Comment
Duration of illness is the largest moderator of response.
By Joel Yager, MD
April 29, 2013
Covering:
Nelson JC et al., Am J Psychiatry 2013 Apr 19
If You Need to Pace the Right Ventricle, Pace the Left as Well
Cardiology Summary and Comment
Free
In patients with atrioventricular block and LVEFs
By Mark S. Link, MD
April 24, 2013
Covering:
Curtis AB et al., N Engl J Med 2013 Apr 25; 368:1585
Photoagene? Susceptibility to Sun Damage Is Genetic
Dermatology Summary and Comment
Researchers locate a single nucleotide polymorphism that is associated with less photoaging of the facial skin.
By Mark V. Dahl, MD
April 19, 2013
Covering:
Le Clerc S et al., J Invest Dermatol 2013 Apr; 133:929
Does Decision Making Have to Get Harder as We Age?
Psychiatry Summary and Comment
Vulnerability to scams is related to decreased, and possibly treatable, detection of reward prediction error when making choices.
Renin-Angiotensin-Aldosterone System Blockade for HF: More Is Not Better
Cardiology Summary and Comment
Adding a direct renin inhibitor to standard medical treatments failed to improve clinical outcomes.
Measuring Coronary Artery Calcium in People with Type 2 Diabetes Identifies a Low-Risk Subset
General Medicine Summary and Comment
Coronary calcium scores might help stratify risk for adverse cardiovascular events.
More Colorectal Cancers Are Missed in Patients with IBD
Gastroenterology Summary and Comment
Risk for early/missed cancer after colonoscopy was 3 times higher in U.S. Medicare patients with inflammatory bowel disease than in those without.
By Douglas K. Rex, MD
April 5, 2013
Covering:
Wang YR et al., Am J Gastroenterol 2013 Mar; 108:444
Intermittent Androgen Deprivation Therapy for Metastatic Prostate Cancer?
A randomized study failed to show that intermittent therapy was noninferior to continuous therapy with respect to survival.
Extended-Release Carbidopa/Levodopa for Parkinson Disease
Neurology Summary and Comment
Should patients with Parkinson disease switch to extended-release carbidopa/levodopa formulations?
By Michael S. Okun, MD
April 2, 2013
Covering:
Hauser RA et al., Lancet Neurol 2013 Apr; 12:346
Coaching and Physiotherapy for Sedentary Parkinson Disease Patients
Neurology Summary and Comment
A tailored behavior-based exercise program did not improve level of activity on a questionnaire but improved secondary measures of physical activity and fitness.
Clopidogrel Is Safe Before Hip Fracture Surgery
General Medicine Summary and Comment
Free
In an observational study, clopidogrel did not confer risk for serious perioperative bleeding.
By Allan S. Brett, MD
March 28, 2013
Covering:
Feely MA et al., Mayo Clin Proc 2013 Feb; 88:149
Excess Risk for Hip Fracture Among Nursing Home Residents Who Take Nonbenzodiazepine Hypnotics
General Medicine Summary and Comment
Risk was particularly elevated among new users.
HCM Seldom Lethal in Patients Who Survive to Age 60
Cardiology Summary and Comment
In a registry study, the cause of death in older patients was usually unrelated to HCM.
By Mark S. Link, MD
March 27, 2013
Covering:
Maron BJ et al., Circulation 2013 Feb 5; 127:585
Can Trauma Precipitate Shingles?
General Medicine Summary and Comment
An analysis suggests a cause–effect relation, but this connection should be clinically confirmed.
By Abigail Zuger, MD
March 26, 2013
Covering:
Zhang JX et al., J Infect Dis 2013 Mar 15; 207:1007
Older Survivors of In-Hospital Cardiac Arrest Have Better Prognoses Than Expected
Hospital Medicine Summary and Comment
1- and 3-year survival rates were 59% and 44%, respectively.
An Approach to Solitary Pulmonary Nodules
General Medicine Summary and Comment
Experts have published an exhaustive review, with new algorithms for evaluation and management.
By Allan S. Brett, MD
March 19, 2013
Covering:
Patel VK et al., Chest 2013 Mar; 143:825
Patel VK et al., Chest 2013 Mar; 143:840
Wiener RS et al., Chest 2013 Mar; 143:672
Midlife Cardiorespiratory Fitness Might Attenuate Later-Life Dementia
General Medicine Summary and Comment
Later dementia was less common among people who were more fit before age 65.
More Evidence of Risk for Age-Related Macular Degeneration with Aspirin Use
General Medicine Summary and Comment
But the data aren't strong enough to overturn use of aspirin for evidence-based indications.
By Thomas L. Schwenk, MD
March 14, 2013
Covering:
Liew G et al., JAMA Intern Med 2013 Feb 25; 173:258
Kaul S and Diamond GA., JAMA Intern Med 2013 Feb 25; 173:264
Does Anti–Tumor Necrosis Factor Therapy Elevate Herpes Zoster Risk?
General Medicine Summary and Comment
For patients with rheumatoid arthritis, inflammatory bowel disease, and psoriasis, anti-TNF therapy poses no excess risk for HZ.
Spironolactone for HF with Preserved LVEF Improves Diastolic Function — But Not Symptoms
Cardiology Summary and Comment
In a randomized trial, significant echocardiographic improvements failed to translate into favorable clinical outcomes.
By Joel M. Gore, MD
March 13, 2013
Covering:
Edelmann F et al., JAMA 2013 Feb 27; 309:781
Cleland JGF and Pellicori P., JAMA 2013 Feb 27; 309:825
Intensive Life Support After Major Surgery: The Surgeon's Perspective
General Medicine Summary and Comment
Many surgeons believe that withdrawing life support during the first postoperative week is unacceptable.
By Patricia Kritek, MD
March 12, 2013
Covering:
Paul Olson TJ et al., JAMA Surg 2013 Jan; 148:29
Schwarze ML et al., Crit Care Med 2013 Jan; 41:1
Does More Diagnostic Testing Lower Patient Anxiety?
General Medicine Summary and Comment
No, although slightly fewer follow-up primary care visits occurred.
By Thomas L. Schwenk, MD
March 12, 2013
Covering:
Rolfe A and Burton C., JAMA Intern Med 2013 Feb 25
Kroenke K., JAMA Intern Med 2013 Feb 25
