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Category: Cardiology | Monthly Briefing

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August 2009 Briefing - Cardiology

Last Updated: September 01, 2009.

 

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Here are what the editors at HealthDay consider to be the most important developments in Cardiology for August 2009. This roundup includes the latest research news from journal articles, as well as the FDA approvals and regulatory changes that are the most likely to affect clinical practice.

Liver Fat, Not Visceral Fat, Linked to Obesity

MONDAY, Aug. 31 (HealthDay News) -- High levels of intrahepatic fat correlate better with metabolic changes associated with obesity than visceral fat, according to a study published online Aug. 24 in the Proceedings of the National Academy of Sciences.

Abstract
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Testosterone Linked to Improvements in Heart Failure

MONDAY, Aug. 31 (HealthDay News) -- Testosterone supplementation may improve functional capacity, muscle strength, and glucose metabolism in older men with chronic heart failure, according to research published in the Sept. 1 issue of the Journal of the American College of Cardiology.

Abstract
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Editorial (subscription or payment may be required)

Hopeless Outlook Linked With Atherosclerosis in Women

FRIDAY, Aug. 28 (HealthDay News) -- Women who show signs of hopelessness are more likely to have subclinical atherosclerosis compared to their more optimistic counterparts, according to a study published online Aug. 27 in Stroke, while a second study found that the extent of apathy a stroke patient feels has an important impact on stroke outcomes.

Abstract - Whipple
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Abstract - Mayo
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Low-Carb, High-Protein Diet Linked to Atherosclerosis

FRIDAY, Aug. 28 (HealthDay News) -- Mice on a low-carbohydrate, high-protein (LCHP) diet had more aortic atherosclerosis than mice on a typical "Western" diet, despite less weight gain and similar blood lipids, according to a study published online Aug. 24 in the Proceedings of the National Academy of Sciences.

Abstract
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Quality of Care Unchanged Under New Payment System

FRIDAY, Aug. 28 (HealthDay News) -- The implementation of a fixed-price, payment-by-results system for hospitals in the United Kingdom, beginning in 2002, has reduced the length of hospital stays and increased day case (outpatient) admissions, but has had no measurable effect on quality of care, according to a study published Aug. 27 in BMJ.

Abstract
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Peripheral Arterial Disease Linked to Recurrence of Stroke

FRIDAY, Aug. 28 (HealthDay News) -- Patients who have asymptomatic peripheral arterial disease after a stroke or transient ischemic attack are more likely to have another stroke or vascular event, according to a study published online on Aug. 27 in Stroke.

Abstract
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One in Seven Readmitted After Revascularization

FRIDAY, Aug. 28 (HealthDay News) -- Readmission after percutaneous coronary intervention (PCI) occurs in 14.6 percent of cases, and rehospitalization within 30 days of undergoing the procedure is associated with higher odds of mortality, according to a study published in the Sept. 1 issue of the Journal of the American College of Cardiology.

Abstract
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Editorial (subscription or payment may be required)

Diastolic Blood Pressure Linked to Impaired Cognition

THURSDAY, Aug. 27 (HealthDay News) -- Higher diastolic blood pressure (DBP) may be associated with a greater risk of impaired cognitive status in middle-aged and older individuals, according to research published in the Aug. 25 issue of Neurology.

Abstract
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Study Shows How Low Vitamin D May Influence Heart Risk

THURSDAY, Aug. 27 (HealthDay News) -- In people with diabetes, vitamin D may inhibit foam cell creation by reducing acetylated or oxidized low-density lipoprotein (LDL) cholesterol uptake in macrophages, according to research published in the Aug. 25 issue of Circulation.

Abstract
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Cardiovascular Risks Linked to Dementia Hospitalization

THURSDAY, Aug. 27 (HealthDay News) -- Smoking, hypertension and diabetes in midlife are associated with hospitalization for dementia later in life, according to a study published online Aug. 19 in the Journal of Neurology, Neurosurgery & Psychiatry.

Abstract
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New Sensitive Troponin Assays May Identify Heart Attacks

WEDNESDAY, Aug. 26 (HealthDay News) -- In patients presenting with signs and symptoms of heart attack, new sensitive cardiac troponin assays may significantly improve the early diagnosis of acute myocardial infarction, according to two studies published in the Aug. 27 issue of the New England Journal of Medicine.

Abstract - Reichlin
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Abstract - Keller
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Editorial (subscription or payment may be required)

Annual Radiation Exposure Often High in Younger Adults

WEDNESDAY, Aug. 26 (HealthDay News) -- In young and middle-aged adults, imaging procedures are a significant source of exposure to ionizing radiation and in some cases can lead to high and very high cumulative effective doses, according to a study published in the Aug. 27 issue of the New England Journal of Medicine.

Abstract
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Perspective (subscription or payment may be required)

Magnetic Resonance Imagining Can Monitor Carotid Narrowing

WEDNESDAY, Aug. 26 (HealthDay News) -- High-spatial-resolution, 1.5-T magnetic resonance imaging of the carotid artery can monitor plaque build-up in atherosclerotic disease, a progression slowed by statin therapy, according to a study in the September issue of Radiology.

Abstract
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Gender Affects Mortality After Acute Coronary Syndromes

TUESDAY, Aug. 25 (HealthDay News) -- Women have different short-term death rates than men following acute coronary syndromes (ACS) depending on clinical presentation, although this appears to be largely due to differences in angiographic disease severity, according to a study in the Aug. 26 issue of the Journal of the American Medical Association.

Abstract
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Gene Variant Can Dampen Effect of Antiplatelet Therapy

TUESDAY, Aug. 25 (HealthDay News) -- Clopidogrel's effectiveness in antiplatelet therapy for patients with acute coronary syndromes or those who have had percutaneous coronary intervention (PCI) can be dampened for those who have the CYP2C19*2 gene variant, according to a study in the Aug. 26 issue of the Journal of the American Medical Association.

Abstract
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Hormones Hike Death Risk in Some Prostate Cancers

TUESDAY, Aug. 25 (HealthDay News) -- Men with prostate cancer who receive neoadjuvant hormone therapy in combination with radiotherapy face an increased all-cause mortality risk if they have significant cardiovascular comorbidities, including congestive heart failure or prior myocardial infarction, according to a study reported in the Aug. 26 issue of the Journal of the American Medical Association.

Abstract
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Department Issues New HIPAA Notification Regulations

TUESDAY, Aug. 25 (HealthDay News) -- The U.S. Department of Health and Human Services issued new regulations on Aug. 19 requiring entities covered by the Health Insurance Portability and Accountability Act (HIPAA) to notify individuals after their health information has been breached.

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Medication Reviews Can Keep Hospitalization Rates Down

TUESDAY, Aug. 25 (HealthDay News) -- Collaborative medicine reviews for patients treated with heart failure medicines are effective in delaying the time to next hospitalization for heart failure, according to a study published online Aug. 19 in Circulation: Heart Failure.

Abstract
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AHA Recommends Limiting Added Dietary Sugars

TUESDAY, Aug. 25 (HealthDay News) -- Americans' average daily intake of added sugars significantly exceeds discretionary calorie allowances, regardless of energy needs, and should be reduced by up to three-quarters, according to an American Heart Association Scientific Statement published online Aug. 24 in Circulation.

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Smokers' Vehicles Contain High Nicotine Concentrations

TUESDAY, Aug. 25 (HealthDay News) -- Motor vehicles operated by smokers have higher concentrations of nicotine than those found even in restaurants and bars, according to a pilot study published online Aug. 24 in Tobacco Control.

Abstract
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Non-Infectious Disease in South Africa Growing Burden

TUESDAY, Aug. 25 (HealthDay News) -- South Africa is struggling under the quadruple burden of communicable disease, non-communicable disease, perinatal and maternal ill-health, and disorders arising from injury in both urban and rural settings, according to a study published online Aug. 25 in a special edition of The Lancet focusing on health in South Africa.

Abstract
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Sleep-Disordered Breathing May Raise Mortality Risk

FRIDAY, Aug. 21 (HealthDay News) -- Sleep-disordered breathing may be associated with higher all-cause and cardiovascular-related mortality in middle-aged and older people, particularly men, according to research published online Aug. 18 in PLoS Medicine.

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Health Care Financing Model Rewards Efficient Care

FRIDAY, Aug. 21 (HealthDay News) -- A health care financing model that includes incentives for reducing potentially avoidable costs can act as a bridge between the current fragmented system and one based on high-value care, according to an article published online Aug. 19 in the New England Journal of Medicine.

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U.S. Life Expectancy Reaches 77.9 Years

THURSDAY, Aug. 20 (HealthDay News) -- Life expectancy in the United States has increased again, from 77.7 to 77.9 years -- a new record -- according to statistics released Aug.19 by the U.S. Centers for Disease Control and Prevention.

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News Release

Drug-Eluting Stents Fare Well Versus Bare-Metal Stents

THURSDAY, Aug. 20 (HealthDay News) -- Implantation of a drug-eluting stent following percutaneous coronary intervention for unprotected left main coronary artery disease (ULMCA) decreases the risk of cardiovascular events and stroke compared to a bare-metal stent, according to a study published online Aug. 19 in the Journal of the American College of Cardiology.

Abstract
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Editorial

FDA Launches New Center for Tobacco Products

WEDNESDAY, Aug. 19 (HealthDay News) -- The U.S. Food and Drug Administration has announced the launch of its Center for Tobacco Products, an agency armed with the mission of developing and implementing public health strategies to reduce the burden of illnesses and deaths caused by tobacco products nationwide.

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Smokeless Tobacco Linked to Cardiovascular Risks

WEDNESDAY, Aug. 19 (HealthDay News) -- Users of smokeless tobacco may have an increased risk of fatal myocardial infarction and stroke, according to a study published online Aug. 18 in BMJ.

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Use of Implantable Cardiac Defibrillators Reviewed

WEDNESDAY, Aug. 19 (HealthDay News) -- Use of implantable cardioverter-defibrillators should be based on the available scientific evidence and a physician's judgment based on the individual patient, according to a review in the Aug. 25 issue of the Journal of the American College of Cardiology.

Abstract
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Pioglitazone Linked to Lower Risks in Older Diabetics

WEDNESDAY, Aug. 19 (HealthDay News) -- In elderly diabetics, pioglitazone may be associated with a significantly lower risk of heart failure and death than rosiglitazone, according to a study published online Aug. 18 in BMJ.

Abstract
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Editorial

Personality Type Linked to Increased Mortality

WEDNESDAY, Aug. 19 (HealthDay News) -- In patients with peripheral arterial disease, Type D personality -- which is characterized by negative emotions and inhibited self-expression during social interactions -- is an independent predictor of all-cause mortality, according to a pilot study published in the August issue of the Archives of Surgery.

Abstract
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Post-Heart Attack Mortality Rate Has Declined Since 1995

TUESDAY, Aug. 18 (HealthDay News) -- The 30-day mortality rate for older patients released from the hospital after acute myocardial infarction has declined since 1995, according to a study in the Aug. 19 issue of the Journal of the American Medical Association.

Abstract
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Kidney Disease May Worsen Outcomes in Heart Condition

TUESDAY, Aug. 18 (HealthDay News) -- Patients with acute coronary syndromes undergoing an early, invasive strategy who also have chronic kidney disease (CKD) have worse clinical outcomes, according to a study in the August issue of the Journal of the American College of Cardiology: Cardiovascular Interventions.

Abstract
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Iron Supplementation May Be Harmful During Pregnancy

TUESDAY, Aug. 18 (HealthDay News) -- Iron supplementation during mid-pregnancy is associated with a higher likelihood of gestational diabetes, hypertension and metabolic syndrome, according to a study in the August issue of the American Journal of Obstetrics & Gynecology.

Abstract
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Poor Guideline Adherence Found for Mitral Regurgitation

TUESDAY, Aug. 18 (HealthDay News) -- Only about half of patients with mitral regurgitation (MR) undergo surgery as recommended by accepted guidelines, even though about three-quarters of unoperated patients have at least one indication for surgery, according to a study in the Aug. 25 issue of the Journal of the American College of Cardiology.

Abstract
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High Inflammation, Low Heart Disease in Amazonian Tribe

MONDAY, Aug. 17 (HealthDay News) -- As shown by an Amazonian population with high rates of inflammation and infection but low adiposity and robust fitness, inflammation is not always a risk factor for arterial degeneration and cardiovascular disease, according to research published Aug. 11 in PLoS One.

Abstract
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Admission Glucose in ACS Linked to Adverse Events

MONDAY, Aug. 17 (HealthDay News) -- Elevated fasting glucose upon admission for acute coronary syndrome is associated with in-hospital and six-month adverse events, according to research published Aug. 15 in the American Journal of Cardiology.

Abstract
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Triglyceride Level Can Predict Risk of Cardiovascular Events

MONDAY, Aug. 17 (HealthDay News) -- Even slightly increased triglyceride levels are associated with a higher risk of recurring cardiovascular events in heart disease patients treated with statins, though that link is diminished when other variables are considered, according to a study in the Aug. 15 American Journal of Cardiology.

Abstract
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Alarm Symptoms Often Do Not Result in Timely Diagnosis

FRIDAY, Aug. 14 (HealthDay News) -- Many patients who present with certain alarm symptoms, including hematuria and rectal bleeding, do not receive a diagnosis in a reasonable amount of time, according to a study published online Aug. 13 in BMJ.

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Framingham Risk Factors' Value Seems to Decrease With Age

FRIDAY, Aug. 14 (HealthDay News) -- The predictive value of conventional risk factors for cardiovascular disease (CVD) appears to decrease in older adults, with C-reactive protein (CRP) providing little additional value, according to research published in the Aug. 15 issue of the American Journal of Cardiology.

Abstract
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High Urinary Albumin Affects Death Risk for Heart Failure

FRIDAY, Aug. 14 (HealthDay News) -- An elevated urinary albumin to creatinine ratio (UACR) is a predictor of cardiovascular events and death in heart failure patients and may offer clinicians a prognostic guide for risk stratification, according to a study reported in the Aug. 15 issue of The Lancet.

Abstract
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Procedure Offers Alternative to Warfarin for Stroke Risk

FRIDAY, Aug. 14 (HealthDay News) -- Atrial fibrillation patients at risk of stroke may benefit from percutaneous closure of the left atrial appendage (LAA) as an alternative to long-term warfarin therapy, according to a study in the Aug. 15 issue of The Lancet.

Abstract
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Tight Blood Pressure Control Averts Ventricular Hypertrophy

FRIDAY, Aug. 14 (HealthDay News) -- A regime of tight blood pressure control can reduce the incidence of ventricular hypertrophy in non-diabetic patients with hypertension better than usual control, according to a study in the Aug. 15 issue of The Lancet.

Abstract
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CT Angiography Shows 'Real World' Benefit in Heart Disease

FRIDAY, Aug. 14 (HealthDay News) -- Computed tomographic coronary angiography (CTCA) appears extremely useful in predicting freedom from cardiovascular events in lower-risk patients, which could cut down on more costly invasive angiography, according to research published in the Aug. 15 issue of the American Journal of Cardiology.

Abstract
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Magnetic Resonance Imaging Has Role in Cardiac Workup

FRIDAY, Aug. 14 (HealthDay News) -- Patient workup using cardiovascular magnetic resonance (CMR) imaging is indicated for several major cardiac conditions and can have a substantial impact on diagnosis and patient management, according to a study published online Aug. 12 in the Journal of the American College of Cardiology.

Abstract
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Healthy Lifestyle Helps Prevent Chronic Diseases

THURSDAY, Aug. 13 (HealthDay News) -- Patients who practice four simple lifestyle behaviors -- never smoking, maintaining a body mass index lower than 30, engaging in at least 3.5 hours per week of physical activity, and consuming a diet rich in fruits, vegetables, and whole grains -- can significantly decrease their risk of chronic diseases, according to a study in the Aug. 10/24 issue of the Archives of Internal Medicine.

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Discharge Summaries Often Lack Pending Test Results

THURSDAY, Aug. 13 (HealthDay News) -- Hospital discharge summaries often do not contain information on pending test results or provider follow-up information, which can lead to medical errors, according to a study in the September issue of the Journal of General Internal Medicine.

Abstract
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FDA Aims to Ease Access to Investigational Drugs

WEDNESDAY, Aug. 12 (HealthDay News) -- The U.S. Food and Drug Administration (FDA) has published two new rules to help seriously ill patients gain access to investigational drugs and biologics, according to an Aug. 12 release issued by the agency.

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Visceral Fat, Social Stress, Atherosclerosis Linked

WEDNESDAY, Aug. 12 (HealthDay News) -- There is a direct relationship between coronary artery atherosclerosis, a high visceral to subcutaneous abdominal fat ratio, and social stress, supporting the hypothesis that social stress may worsen coronary artery atherosclerosis by increasing the amount of visceral fat in the body, according to research published in the August issue of Obesity.

Abstract
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Electronic Letters Help Cardiac Patients Stay Healthy

TUESDAY, Aug. 11 (HealthDay News) -- Coronary artery disease patients who have been discharged from a pharmacy cardiovascular disease management service can still maintain their low-density lipoprotein cholesterol (LDL-C) goals with the help of electronic reminder letters, according to a study in the August issue of the American Journal of Managed Care.

Abstract
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Hospitalist's Effect on Quality of Care Measured

TUESDAY, Aug. 11 (HealthDay News) -- Hospitals that have hospitalists provide higher-quality care for a number of conditions and dimensions of care, according to a study in the Aug. 10/24 issue of the Archives of Internal Medicine.

Abstract
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Editorial

Imaging Framework Allows Virtual Planning of Surgery

TUESDAY, Aug. 11 (HealthDay News) -- A noninvasive image-based surgical framework allows surgeons to perform virtual surgeries and test various scenarios where postoperative hemodynamics are particularly important, such as Fontan failure, according to a study in the August issue of the Journal of the American College of Cardiology: Cardiovascular Imaging.

Abstract
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Aortic Sclerosis Linked to Platelet NO Resistance

TUESDAY, Aug. 11 (HealthDay News) -- In older adults, aortic sclerosis is associated with platelet nitric oxide resistance but not with conventional coronary risk factors, which may explain why patients with aortic sclerosis have an increased risk of developing blood clots, according to a study in the August issue of the Journal of the American College of Cardiology: Cardiovascular Imaging.

Abstract
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Editorial (subscription or payment may be required)

Optimism, Lower Hostility Linked to Reduced Mortality

TUESDAY, Aug. 11 (HealthDay News) -- Both optimism and cynical hostility are independently associated with cancer and coronary heart disease outcomes, including mortality, according to research published online Aug. 10 in Circulation.

Abstract
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Weight Loss Method and Cardiac Health Examined

TUESDAY, Aug. 11 (HealthDay News) -- Obese people with no known cardiovascular risk factors who lose a considerable amount of weight have significant improvements in cardiac health, according to a study in the Aug. 18 issue of the Journal of the American College of Cardiology.

Abstract
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Editorial (subscription or payment may be required)

Vascular Surgery Studies Under-Represent Some Groups

MONDAY, Aug. 10 (HealthDay News) -- In vascular surgery randomized controlled trials, women and minorities are under-reported and under-represented, especially in small, privately funded, and single-center trials, according to a study in the August issue of the Journal of Vascular Surgery.

Abstract
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Midlife Cholesterol Level Linked to Alzheimer's Risk

MONDAY, Aug. 10 (HealthDay News) -- In middle age, even mildly elevated cholesterol levels are associated with a significantly increased risk of dementia later in life, according to a study published online Aug. 4 in Dementia and Geriatric Cognitive Disorders.

Abstract
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Cause of Cognitive Decline After Heart Bypass Examined

MONDAY, Aug. 10 (HealthDay News) -- Use of a pump during coronary artery bypass surgery does not appear to be responsible for long-term loss of cognitive function and memory in patients with coronary artery disease; it instead may be due to the disease itself, according to a study in the August issue of the Annals of Thoracic Surgery.

Abstract
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Editorial (subscription or payment may be required)

Sudden Deaths in Young Lacrosse Players Appear Rare

MONDAY, Aug. 10 (HealthDay News) -- Sudden death among young competitive lacrosse players appears rare, though commotio cordis may be a particular concern among these players, according to research published online Aug. 10 in Pediatrics.

Abstract
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X-ray Equipment May Help Spread ICU Infections

MONDAY, Aug. 10 (HealthDay News) -- X-ray equipment, and the technicians using it, may represent an important link in cross-infection between patients in intensive care units, according to research published in the August issue of Chest.

Abstract
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HHS Releases Reports on Health Insurance Reform

FRIDAY, Aug. 7 (HealthDay News) -- The U.S. Department of Health and Human Services (HHS) has released a series of state-by-state reports that outline its conclusions on the effects health insurance reform would have on health care for Americans, according to an Aug. 7 release issued by the agency.

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Intervention Found to Improve Depression After Stroke

FRIDAY, Aug. 7 (HealthDay News) -- A brief psychosocial-behavioral intervention, when applied in addition to antidepressant treatment, can markedly reduce both short- and long-term depression following stroke, according to research published online Aug. 6 in Stroke.

Abstract
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Men With Angina Face Significantly Poorer Outcomes

FRIDAY, Aug. 7 (HealthDay News) -- In patients newly diagnosed with angina, five-year outcomes are significantly worse among men than among women, according to a study published online Aug. 6 in BMJ.

Abstract
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Statins Given Day Before Stenting May Improve Results

THURSDAY, Aug. 6 (HealthDay News) -- A single high dose of a statin given a day before stenting is effective in reducing the risk of a heart attack, according to a study published online Aug. 5 in the Journal of the American College of Cardiology.

Abstract
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Prolonged Breath Holding Elevates Brain Damage Marker

WEDNESDAY, Aug. 5 (HealthDay News) -- Divers who hold their breath for several minutes have elevated levels of the protein S100B, which is a marker of brain damage, according to a study published online July 2 in the Journal of Applied Physiology.

Abstract
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Omega-3s Show Benefit in Cardiovascular Conditions

WEDNESDAY, Aug. 5 (HealthDay News) -- Current evidence from decades of studies has shown that omega-3 polyunsaturated fatty acids (PUFA), found primarily in fish oils, can help prevent cardiovascular conditions, according to a review in the Aug. 11 issue of the Journal of the American College of Cardiology.

Abstract
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Pulmonary Hypertension May Be Reversible With Viagra

WEDNESDAY, Aug. 5 (HealthDay News) -- Patients with pulmonary hypertension and heart failure have stiffer arteries and reduced sensitivity to vasodilators compared with patients without hypertension, which can be reversed by sildenafil (Viagra), according to a study in the Aug. 11 issue of the Journal of the American College of Cardiology.

Abstract
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Induced Hypothermia After Cardiac Arrest Is Cost-Effective

WEDNESDAY, Aug. 5 (HealthDay News) -- In cardiac arrest survivors who meet certain criteria, therapeutic hypothermia induced with a cooling blanket improves clinical outcomes and is as cost-effective as many accepted health care interventions, according to a study published online Aug 4 in Circulation: Cardiovascular Quality and Outcomes.

Abstract
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Editorial Opposes European Commission Proposals

TUESDAY, Aug. 4 (HealthDay News) -- The United Kingdom should not accept new proposals from the European Commission that would allow drug companies to provide information about prescription-only drugs over the Internet and in some print publications, according to an editorial published in the August issue of the Drug and Therapeutics Bulletin.

Editorial

Multiple Biomarkers Predict Risk of Cardiovascular Events

TUESDAY, Aug. 4 (HealthDay News) -- Three biomarkers, particularly a marker of endothelial dysfunction, in addition to age can predict the risk of cardiovascular events in patients at high risk of coronary heart disease, according to a study in the Aug. 11 issue of the Journal of the American College of Cardiology.

Abstract
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Links Explored Between Depression, Heart Disease

TUESDAY, Aug. 4 (HealthDay News) -- Having coronary artery disease (CAD) may have a larger sustained effect on the risk of developing major depression than vice-versa, according to research published in the August issue of the Archives of General Psychiatry.

Abstract
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Care Suffers in ACS Patients With Prior Atherosclerosis

TUESDAY, Aug. 4 (HealthDay News) -- Among patients with acute coronary syndrome, those with prior atherosclerosis are more likely to die in-hospital than those without atherosclerosis, and they are also less likely to receive evidence-based treatments, according to a study published online Aug. 3 in Circulation.

Abstract
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Coronary Artery Calcification Score Predicts Heart Outcomes

MONDAY, Aug. 3 (HealthDay News) -- In patients with stable coronary artery disease, coronary artery calcification scores are better long-term predictors of severe cardiac events than single photon emission computed tomographic myocardial perfusion imaging results alone, according to a study published online July 31 in Radiology.

Abstract
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Income, Education Linked to Processed Sugar Intake

MONDAY, Aug. 3 (HealthDay News) -- Intake of sugars added during processing, such as high-fructose corn syrup, is higher in men and in groups with low income and education levels, according to a study in the August issue of the Journal of the American Dietetic Association.

Abstract
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Cardiovascular Risks Higher for Youth With Low Vitamin D

MONDAY, Aug. 3 (HealthDay News) -- A low serum level of vitamin D is associated with increased cardiovascular risk among children and adolescents, according to two studies published online Aug. 3 in Pediatrics.

Abstract - Kumar
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Abstract - Reis
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