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Should Beta Blockers be Used in Heart Failure with Preserved Ejection Fraction?

August 23, 2017
Should Beta Blockers be Used in Heart Failure with Preserved Ejection Fraction?

By Lauren Christene Strazzulla

Peer Reviewed

The lifetime risk for developing heart failure from age 55 on is 33% for men and 28.5% for women, and as the population ages, there is an increasing prevalence of this disease along with its associated health care costs . Heart failure is divisible into 2 distinct entities: those with left ventricular systolic dysfunction and those with cardiovascular compromise that does not decrease LV ejection fraction, which is termed heart failure with persevered ejection fraction (HFpEF) . While …

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Primecuts – This Week in the Journals

August 21, 2017
Primecuts – This Week in the Journals

By Andrew Armanious, MD

Peer Reviewed

This past week, President Trump decided to part ways with White House Chief Strategist Steve Bannon (1). Bannon was a controversial and blunt-spoken political figure who influenced President Trump on many of his contentious campaign decisions. Bannon will be returning to his prior position of executive chairman of Breitbart News.

In world news, thousands of Spaniards in Barcelona assembled along La Rambla in an act of defiance against terrorism less than 24 hours after a van rammed into crowds …

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When Doctors Get Personal

August 18, 2017
When Doctors Get Personal

By Leland Soiefer

Peer Reviewed

Mrs. S sat up straight and made excellent eye contact. Her tone was pleasant. She wore a colorful yellow shirt and dark green pants, and was accompanied by her husband; her gilded rings and earrings added flair to her outfit. Her neutral expression, however, stood out to me. She had seen a doctor several weeks ago regarding her first vaginal bleeding since menopause, and a uterine biopsy showing a precancerous lesion was subsequently performed. Surely by this point she had …

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From the Archives: Are We Too Hesitant to Anticoagulate Elderly Patients with Atrial Fibrillation? A Risk-Benefit Analysis

August 17, 2017
From the Archives: Are We Too Hesitant to Anticoagulate Elderly Patients with Atrial Fibrillation? A Risk-Benefit Analysis

Please enjoy this post from the archives dated June 28, 2013

By Sunny N. Shah, MD

Faculty Peer Reviewed

Background:

Atrial fibrillation (AF) is the most common cardiac arrhythmia and its prevalence increases with age. In fact, the lifetime incidence of AF is approximately 25% in individuals by age 80, with the incidence nearly doubling with each decade of life after age 50. (1) Multiple randomized controlled trials have shown that oral antithrombotic therapy with warfarin or aspirin decreases the risk of ischemic stroke in …

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Primecuts – This Week in the Journals

August 14, 2017
Primecuts – This Week in the Journals

By Jonathan Whitehouse, MD

Peer Reviewed

In New York last week, Mayor de Blasio announced a plan to tax wealthy New Yorkers in order to raise funds for our enfeebled subway system.  It was seen by many as a direct political clash with Governor Cuomo over funding for the Metropolitan Transportation Authority, at a time when the subways are plagued by delays and cancellations, and when both politicians are preparing for elections (1). Other well-documented problems include an “antiquated signal system, severe overcrowding, and trains …

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Tales of Survival: Fighting Words

August 11, 2017
Tales of Survival: Fighting Words

By Rachael Winchester-Hayes, MD

Political friends and foes alike were shocked last month when Senator John McCain’s office announced his diagnosis of glioblastoma after what was thought to be a minor surgery for removal of a blood clot. Watching the reactions unfold on social media, I was struck not just by the bipartisan showing of support – perhaps the first bipartisan action since the election – but also by the combative language used in the tweets, Facebook posts and even official statements.  The White House …

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Are Electronic Cigarettes Safer Than Traditional Cigarettes?

August 9, 2017
Are Electronic Cigarettes Safer Than Traditional Cigarettes?

By Gabriel Lutz

Peer Reviewed

Due to the pervasiveness of television and print marketing of electronic cigarettes (e-cigs) in a multitude of flavors and device designs, e-cig use is on the rise in the general population. As physicians, how should we advise our patients looking to quit smoking or those looking for a “healthier” alternative? What does the evidence say about the health risks of e-cigs in first-time smokers?

Generally, e-cigs are composed of a battery and a vaporization chamber that heats a liquid solution …

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Tales of Survival-The Physician’s Stages of Grief (Based upon the Kübler-Ross Model)

August 4, 2017
Tales of Survival-The Physician’s Stages of Grief (Based upon the Kübler-Ross Model)

By Lauren M. Young

Prologue/Narrowing a Diagnosis.  A 61 year-old African American male, with a longstanding history of right knee and lower back pain, presented to the Emergency Department for the fourth time in one month complaining of pain on the right side of his lower back.  He had also fallen – remarkably not the ‘chief complaint’ for this well-muscled, vibrant man who could “walk from Harlem to Coney Island” just a few weeks prior.  He was surprised when recently his knees “just buckled” …

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