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In patients who have, or are at risk for, coronary artery disease, extended-release niacin added to statin therapy resulted in regression of the carotid intima–media thickness. In contrast, ezetimibe added to statin therapy paradoxically resulted in progression of the carotid intima–media thickness in relation to the extent of reduction of low-density lipoprotein (LDL) cholesterol levels. These findings call into question the use of ezetimibe to lower LDL cholesterol levels.
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Traditional right ventricular apical pacing can, over time, result in deterioration of left ventricular function. In this comparative-effectiveness trial, biventricular pacing prevented the reduction in left ventricular ejection fraction that is seen with right ventricular pacing. The findings have implications for the treatment of patients with bradycardia who require permanent pacing.
The cause of autoimmune pancreatitis is unknown, and distinguishing autoimmune pancreatitis from pancreatic cancer can be difficult. The authors identified an antibody that they were able to detect in about 95% of patients with autoimmune pancreatitis but in only about 5% of patients with pancreatic cancer.
This review focuses on thiazides, the diuretics most often indicated for long-term therapy for hypertension. Thiazide diuretics reduce blood pressure when administered as monotherapy; thiazides also enhance the efficacy of other antihypertensive agents and can reduce hypertension-related morbidity and mortality.
A 46-year-old woman was referred to this hospital because of swelling of the leg and skin changes. She had chronic kidney disease due to congenital ureteral reflux, with recent hemodialysis, and recurrent deep venous thrombosis of the left leg, beginning 2 years earlier. Swelling of the leg persisted, and thickening and erythema of the skin of both legs developed, leading to difficulty walking, sitting, and bending. A skin-biopsy specimen was thought to be consistent with a diagnosis of eosinophilic fasciitis. During the next 14 months, the skin of both legs and one arm became hardened, and difficulty swallowing developed. A diagnostic procedure was performed.
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For the most part, the market doesn't work where health care is concerned. It has been particularly ineffective in constraining costs over the past half-century, with stakeholders (insurance companies, organized medicine, pharmaceutical companies, trial ...
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The premise, based on the Dartmouth Atlas of Health Care, that geographic variations in end-of-life Medicare spending can be used to identify wasted resources was popularized by Peter Orszag, director of the Office of Management and Budget, who has said ...
