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Latest Posts

Eye Health As A Predictor Of Future Disability

The idea that the eyes are a window to the soul traces back through history in many forms, but the idea that the eyes might reveal medical secrets didn’t fall far behind the metaphor.

The clues lie on the retina, which reflects the same microvascular changes that might be seen elsewhere in the body from cardiovascular changes and other diseases. The question now is how to associate retinal changes to specific diseases.

To assess potential associations between retinal microvascular changes with disability in performing activities of daily living, researchers conducted a prospective cohort study of 1,487 community-dwelling, disability-free participants in the Cardiovascular Health Study.

The main outcome measure was Read more »

*This blog post was originally published at ACP Internist*

Research Shows A Higher Risk Of Cardiovascular Disease In Childless Men

Photo by Tracy DuBosar

Married men who have no children have a 17% higher risk of dying from cardiovascular disease after the age of 50 than men with two or more children. But whether that’s because of a physical cause, a sociological effect or self-selection (sick people may choose not to have kids) isn’t known.

To determine if the number of kids predicts cardiovascular death, researchers used data from the NIH-AARP Diet and Health Study of nearly 135,000 men ages 50 to 71 without prior cardiovascular disease who were followed-up for an average of 10 years. That study mailed 3.5 million questionnaires from 1995 through 1996 to AARP members living in California, Florida, Pennsylvania, New Jersey, North Carolina, and Louisiana or in Atlanta or Detroit. Nearly 586,000 people returned the questionnaire, which underwent follow-up surveys in 1996-1997 and 2004-2006. Results appeared online Sept. 26 in the journal Human reproduction.

Almost all (92%) men had Read more »

*This blog post was originally published at ACP Internist*

Preventive Effects Of Aspirin Compared To Outcomes Of Major Bleeding

aspirin by foolsplay07 via Flickr and a Creative Commons license

Treating 1,000 people with preventive aspirin for five years prevents 2.9 major cardiovascular events (nonfatal myocardial infarction, nonfatal stroke, or cardiovascular death) and causes 2.8 major bleeds, according to a meta-analysis.

Nine primary prevention trials compared results for aspirin alone for the primary prevention of cardiovascular disease, and reported data on myocardial infarction, stroke and cardiovascular deaths. Aspirin doses ranged from 100 mg every other day to 500 mg/d, and seven of them studied doses from 75 mg/d to 162.5 mg/d. No dose-dependent effects were noted, the researchers said. Results appeared in the July issue of the American Heart Journal.

A total of 2,029 major cardiovascular events occurred among 52,145 (3.86%) patients allocated to aspirin compared with 2,099 major cardiovascular events among 50,476 (4.16%) patients assigned to placebo or control. Over a mean follow-up of nearly 7 years, aspirin was Read more »

*This blog post was originally published at ACP Internist*

Chocolate’s Effect On Your Health: The Good, The Bad, And The Ugly

Eating a lot of chocolate was associated with a 37% reduction in cardiovascular disease and a 29% reduction in stroke compared eating less, researchers reported. But, people are trending toward record obesity by the year 2030, which is a cardiometabolic risk in its own right.

Chocolate Melting by peter pearson via Flickr and a Creative Commons license

Willie Wonka’s factory wasn’t the only risky place for those with a sweet tooth.

In the first study, to evaluate the association of chocolate with the risk of developing cardiometabolic disorders, researchers performed a meta-analysis of randomized trials, six cohort and one cross-sectional, which reported the association between chocolate and the risk of cardiovascular disease (coronary heart disease and stroke), diabetes, and metabolic syndrome for about 114,000 people.

Because the studies reported chocolate consumption differently, researchers Read more »

*This blog post was originally published at ACP Internist*

Internists Not Using Simple Test (Ankle-Brachial Index) For Peripheral Artery Disease

Despite poor awareness and a lack of training on handling peripheral artery disease, internists can and should be able to recognize the symptoms and manage 95% of such cases. Experts advise using the ankle-brachial index as a quick and effective diagnostic method.

Rebecca J. Beyth, ACP Member, demonstrates the ease and quickness of the ankle-brachial index in diagnosing peripheral artery disease. Photo by Eric Zamora/UF News BureauBut internists often don’t. As was reported in ACP Internist‘s previous cover story on the subject, the ankle-brachial index can be a major part of preventing peripheral artery disease, itself a major predictor of strokes and heart attacks, over and above the Framingham risk score.

The ankle-brachial index is the ratio of the ankle to the arm systolic pressure. A ratio of 0.90 or less indicates peripheral artery disease. Its sensitivity is 79% to 95%, and its specificity is 95% to 100%. It takes less than five minutes to perform in the office.

Yet, among the 85 respondents, 36 (42.35%) said “It’s a quick and easy test.” Another 27 (31.76%) thought, “It’s difficult to fit into the standard visit.” The final 22 (25.88%) said, “I don’t use the ABI to screen patients for PAD.” Read more »

*This blog post was originally published at ACP Internist*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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