Focused Update: Diagnosis and Management of Heart Failure in Adults
Cardiology Clinical Practice Guideline Watch
New recommendations regarding drug therapy in black patients, initiation of pharmacotherapy before hospital discharge, and use of natriuretic peptides; clarification of indications for device therapy
Glucose, Heart Failure, and Mortality
Cardiology Summary and Comment
In patients hospitalized with heart failure, unlike other cardiovascular disorders, elevated glucose levels at admission did not predict mortality.
By Joel M. Gore, MD
April 29, 2009
Covering:
Kosiborod M et al., Circulation 2009 Apr 14; 119:1899
Predicting Stroke in Patients with Asymptomatic Carotid Stenosis?
General Medicine Summary and Comment
Patients who already have CT evidence of silent embolic infarcts are most likely to benefit from surgery.
By Allan S. Brett, MD
April 28, 2009
Covering:
Kakkos SK et al., J Vasc Surg 2009 Apr; 49:902
Long-Term Antipsychotic Use in Alzheimer Disease
Neurology Summary and Comment
Mortality was higher with 1 year of antipsychotic use than with placebo and appeared to increase with longer-term follow-up.
By Zeina Chemali, MD, MPH
April 28, 2009
Covering:
Ballard C et al., Lancet Neurol 2009 Feb; 8:151
Free Copper and Alzheimer Disease
Neurology Summary and Comment
More evidence associates free copper with cognitive decline, but a causative role for copper remains to be established.
By Neeraj Kumar, MD
April 28, 2009
Covering:
Squitti R et al., Neurology 2009 Jan 6; 72:50
Vitamin D Levels in Elders
General Medicine Summary and Comment
Free
Most older people had low serum levels, and at least 25% of elders had frank vitamin D deficiency.
By Allan S. Brett, MD
April 23, 2009
Covering:
Orwoll E et al., J Clin Endocrinol Metab 2009 Apr; 94:1214
Kuchuk NO et al., J Clin Endocrinol Metab 2009 Apr; 94:1244
Exercise Training for Heart Failure Patients
General Medicine Summary and Comment
A supervised aerobic exercise program was safe but only modestly effective.
By Thomas L. Schwenk, MD
April 23, 2009
Covering:
O’Connor CM et al., JAMA 2009 Apr 8; 301:1439
Flynn KE et al., JAMA 2009 Apr 8; 301:1451
Does Screening for Ovarian Cancer Really Help?
General Medicine Summary and Comment
No evidence so far
By Robert W. Rebar, MD
April 21, 2009
Covering:
Partridge E et al., Obstet Gynecol 2009 Apr; 113:775
Mutch DG., Obstet Gynecol 2009 Apr; 113:772
Causes of Excess Mortality Associated with Low and High BMIs
General Medicine Summary and Comment
For both sexes and all ages, 13-year overall mortality was lowest in people with baseline BMIs of 22.5–25 kg/m2 .
By Bruce Soloway, MD
April 21, 2009
Covering:
Whitlock G et al for the Prospective Studies Collaboration., Lancet 2009 Mar 28; 373:1083
Othello Syndrome in Parkinson Disease without Dementia
Neurology Summary and Comment
A review of six cases provides insights into this delusional disorder.
By Scott M. McGinnis, MD
April 21, 2009
Covering:
Cannas A et al., Neurologist 2009 Jan; 15:34
Meat Consumption and Mortality
General Medicine Summary and Comment
Although red-meat intake was linked with shortened longevity, confounding by unmeasured risk factors might partly explain this finding.
USPSTF Recommends Aspirin to Prevent MI in Men, Stroke in Women
General Medicine Clinical Practice Guideline Watch
The task force revised its 2002 recommendations, primarily based on new data for women.
By Richard Saitz, MD, MPH, FACP, FASAM
April 14, 2009
Covering:
Wolff T et al., Ann Intern Med 2009 Mar 17; 150:405
U.S. Preventive Services Task Force., Ann Intern Med 2009 Mar 17; 150:396
Vasomotor Symptoms and Other Signs of Estrogen Deficiency
General Medicine Summary and Comment
Hot flashes can be associated with insomnia and loss of BMD.
By Robert W. Rebar, MD
April 14, 2009
Covering:
Gast G-CM et al., Menopause 2009 Mar/Apr; 16:231
Ensrud KE et al., Menopause 2009 Mar/Apr; 16:286
Laparoscopic Prostatectomy: Experience Matters
The more practiced the surgeon, the less the likelihood of cancer recurrence.
Could B12 and Folate Deficiencies Cause Brain Atrophy and Dementia?
Neurology Summary and Comment
In one study of community-dwelling elders, folate and B12 levels correlated with brain atrophy; in another, these vitamins correlated with incident dementia.
By Laurence J. Kinsella, MD
April 14, 2009
Covering:
Vogiatzoglou A et al., Neurology 2008 Sep 9; 71:826
Kim J-M et al., J Neurol Neurosurg Psychiatry 2008 Aug; 79:864
Validation of a Universal Rule for Termination of Resuscitation in the Field
Emergency Medicine Summary and Comment
No survivors would have been missed if the rule had been applied to this study’s large sample of out-of-hospital cardiac arrest cases with presumed cardiac etiology.
By Daniel J. Pallin, MD, MPH
April 10, 2009
Covering:
Morrison LJ et al., Resuscitation 2009 Mar; 80:324
Religious Coping and End-of-Life Care
General Medicine Summary and Comment
Strong positive religious beliefs were associated with intensive life-prolonging care.
One Bad Break Leads to Another
Women's Health Summary and Comment
Risk for hip fracture was six times higher during the first year after a proximal humeral fracture.
By Wendy S. Biggs, MD
April 9, 2009
Covering:
Clinton J et al., J Bone Joint Surg Am 2009 Mar 1; 91:503
Exercise Training in Patients with LV Systolic Dysfunction
Cardiology Summary and Comment
Free
Data from a large randomized trial demonstrate that exercise therapy is safe, but the health gains are modest.
Dronedarone — A New Option for Atrial Fibrillation?
General Medicine Summary and Comment
A new drug promises efficacy and safety for AF patients.
Physical Activity and Mortality in 50-Year-Old Men
General Medicine Summary and Comment
Boosting physical activity has the same long-term effect on mortality as does smoking cessation.
Balloon Kyphoplasty for Spinal Compression Fracture
General Medicine Summary and Comment
At 1 month, kyphoplasty patients had significantly greater improvements in global quality of life, back pain, and function than did controls.
By Bruce Soloway, MD
April 7, 2009
Covering:
Wardlaw D et al., Lancet 2009 Mar 21; 373:1016
Kallmes DF and Jarvik JG., Lancet 2009 Mar 21; 373:982
Are Disseminated Tumor Cells Prognostic in Prostate Cancer?
Cytokeratin-positive cells detected postoperatively in bone marrow conferred excess risk for subsequent metastases.
By Robert Dreicer, MD, MS, FACP
April 7, 2009
Covering:
Weckermann D et al., J Clin Oncol 2009 Apr 1; 27:1549
Scher HI and Pantel K., J Clin Oncol 2009 Apr 1; 27:1531
Primary-Care CBT for GAD in Adults Older Than Age 60
Psychiatry Summary and Comment
Lacking the adverse effects of medications, this psychotherapy should become a first-line treatment for many.
Age and Bleeding Risk with Bivalirudin vs. Heparin plus a GP IIb/IIIa Inhibitor in Patients with ACS
Emergency Medicine Summary and Comment
Bleeding was significantly less common with bivalirudin than with heparin plus a GP IIb/IIIa inhibitor, regardless of age.
By Daniel J. Pallin, MD, MPH
April 3, 2009
Covering:
Lopes RD et al., J Am Coll Cardiol 2009 Mar 24; 53:1021
