• Shift Work Is Associated with Adverse...

    Added On : 31st August 2012

    Shift Work Is Associated with Adverse Vascular Events

    Shift workers experienced more adverse coronary events and myocardial infarctions than non–shift workers.

  • GOLD 2011 Guidelines — New Assessment System...

    Added On : 14th September 2012

    GOLD 2011 Guidelines — New Assessment System to Guide Therapy of COPD Patients

  • Pulmonary Artery Enlargement on CT Scan...

    Added On : 27th September 2012

    Pulmonary Artery Enlargement on CT Scan Predicts COPD Exacerbation

    Now we need data showing that computed tomography measurements improve chronic obstructive pulmonary disease outcomes.

    Some patients with advanced chronic obstructive pulmonary disease (COPD) have enlargement of the pulmonary artery (PA), reflecting pulmonary hypertension. Using two cohorts of several thousand patients with COPD, researchers examined whether the diameter of the main pulmonary artery on noncontrast computed tomography (CT) predicts COPD exacerbations. Researchers evaluated the ratio of the diameter of the main pulmonary artery (at the level of its bifurcation) to the diameter of the ascending aorta (on the same axial CT image) — the PA:A ratio (figure).

  • Brain Infarction Is Associated with Monocular Visual Loss

    Added On : 10th October 2012

    Twenty-four percent of patients with retinal ischemia had concomitant brain ischemic lesions.

    When monocular visual loss is secondary to retinal ischemia, the etiology usually is embolic. In this retrospective study of 129 patients who presented to a Boston emergency department with monocular visual loss of presumed ischemic origin, researchers sought to determine the prevalence of concurrent acute brain infarction (identified by diffusion-weighted magnetic resonance imaging [DWI]). Visual loss was transient in 57% of patients and permanent in 43%.

  • Vitamin D's Effect on Calcium Absorption

    Added On : 23rd October 2012

    Supplemental vitamin D enhanced calcium absorption very little among women with mild vitamin D insufficiency.

    In a recent randomized trial, 163 postmenopausal women with mild vitamin D insufficiency (mean 25[OH]D level, 16 ng/mL) received doses of vitamin D3 ranging from 400 IU to 4800 IU daily. Doses 800 IU daily were sufficient to boost levels above 20 ng/mL in nearly all women who received these doses (JW Gen Med Apr 26 2012). Because a goal of vitamin D supplementation is to ensure adequate intestinal absorption of calcium, these researchers now present additional findings on the relation between vitamin D dosing and calcium absorption. Participants ingested a standard dose of radioactive calcium, and serum radiocalcium was measured 2 hours later.

  • Feeding Tubes in Patients with Advanced Dementia

    Added On : 5th November 2012

    Tube feedings did not extend life in a nursing home cohort.

    Some surrogate decision makers opt for placing percutaneous endoscopic gastrostomy (PEG) tubes to prolong life in patients with advanced dementia. Researchers used the Minimum Data Set (a federally mandated comprehensive assessment of nursing home residents) and Medicare claims data to determine whether PEG tubes actually delayed death in 36,000 nursing home residents with advanced dementia who had recently transitioned to a need for assistance with eating.

  • Once-Yearly Zoledronic Acid...

    Added On : 18th November 2012

    Once-Yearly Zoledronic Acid for Men with Osteoporosis

    This drug lowered the incidence of radiographic, but not clinical, vertebral fractures.

  • Varenicline Isn't Associated with Excess Risk...

    Added On : 1st December 2012

    Varenicline Isn't Associated with Excess Risk for Adverse Cardiovascular Events

    Evidence suggests that varenicline is as safe as bupropion.

    Varenicline (Chantix) is a partial nicotine-receptor agonist that is used to facilitate smoking cessation. In a recent meta-analysis of randomized, placebo-controlled trials, varenicline use was not associated with excess risk for adverse cardiovascular (CV) events during or within 30 days after stopping treatment (JW Gen Med May 22 2012). In this new nationwide observational study from Denmark, researchers compared risk for adverse CV events in 18,000 new users of varenicline and 18,000 new users of bupropion for smoking cessation. Major CV events included acute coronary syndrome, ischemic stroke, and CV-related death.

  • Probiotics to Prevent Clostridium difficile–Associated Diarrhea

    Added On : 14th December 2012

    Probiotic prophylaxis lowered the incidence of CDAD by 66%.

    Antibiotic treatment disturbs the normal gastrointestinal flora and raises risk for Clostridium difficile–associated diarrhea (CDAD). To evaluate the effectiveness and safety of probiotics for preventing CDAD, researchers performed a systematic review and meta-analysis. CDAD was defined as an episode of diarrhea associated with a positive C. difficile culture or toxin assay.

  • Thyroid Function and Risk for AF: A Linear Relation

    Added On : 27th December 2012

    Patients with even subclinical hyperthyroidism had excess risk for atrial fibrillation.

    Patients with overt hyperthyroidism (suppressed thyroid-stimulating hormone [TSH] and elevated free thyroxine [T4] levels) have excess risk for developing atrial fibrillation (AF). However, the relations between subclinical hyperthyroidism (suppressed TSH and normal T4), overt hypothyroidism (elevated TSH and low T4), and subclinical hypothyroidism (elevated TSH and normal T4) are unclear.