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Jun 26, 2017

Among Medicare recipients, from 2000 to 2010, there was a whopping 83-fold increase (that’s an 8300% increase!) in the number of blood tests performed to determine their vitamin D status.1 What could possibly cause such a dramatic increase?  While the aging U.S.

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Mar 13, 2017

Could automated, web-based cognitive behavioral therapy (CBT) replace flesh-and-blood healthcare practitioners?  Can computers deliver healthcare at lower cost and similar quality to face-to-face interactions with humans? Several web-based CBT programs have been developed and are now being marketed directly to consumers.  But do they actually work?

 

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Feb 9, 2017

About 5 million Americans are currently living with heart failure (HF) and an astounding 24-42% of them also suffer from depression.1,2 One meta-analysis found a greater than 2-fold risk of death in patients with HF and comorbid depression.  Depressed patients with HF are more likely to be hospitalized, seek care from emergency rooms, and rack up big bills.3  Not surprisingly, patients with HF and depression have a much lower quality of life when compared to HF patients

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Jan 25, 2017

Critically evaluating the primary literature and applying the information to patient care is vital to ensuring optimal patient outcomes.  Unfortunately, the foundational knowledge and skills that most of us acquire during our formal education and post-graduate training programs are unlikely to fully prepare us for the challenges and intricacies of interpreting the evolving methods used in clinical drug studies today.  Like the development of any skill, it requires practice and refinement over

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Dec 29, 2016

When you reach a certain age, bowel cleansing becomes a necessary poison.  Colorectal cancer is the third most common type of cancer in the United States with an estimated 95,270 new colon and 39,220 new rectal cancer diagnoses for 2016. More importantly, colorectal cancer (CRC) is the second most common cause of cancer-related mortality in the United States.

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Aug 16, 2016

Persons diagnosed with a psychiatric disorder consume nearly half of all cigarettes smoked in the United States!  Moreover, they are at higher risk for premature death, especially from vascular disease and cancer.1  Smoking cessation efforts are paramount in this population but often more challenging.

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Jul 17, 2016

We're all aware that there is an obesity epidemic and its linked to dozens of health problems.1  But nothing we've done so far — public awareness campaigns, changes in school lunch programs, and approving new drugs for weight loss — has halted this epidemic.  Although the rate of obesity in kids age 2 to 19 has plateaued around 17%, it continues to climb in young adults and most of us keep packing on the pounds as we get older!2

 

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Jun 17, 2016

The list of regimens for Helicobacter pylori eradication is longer than ever.  In recent years, American and European guidelines have recommended clarithromycin-based triple therapy or bismuth-containing quadruple therapy for primary treatment of H.

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May 6, 2016

“Slip! Slop! Slap!

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Apr 8, 2016

Managing behavioral health in persons with dementia is an enormous and growing problem. Today more than 5.3 million Americans are living with Alzheimer’s disease (AD) and that number is expected to increase by 30% by 2025.1 Most patients with AD have challenging neuropsychiatric symptoms such as agitation.

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Dec 31, 2015

Several studies have evaluated the correlation between low-dose aspirin and NSAID use and the development of colorectal cancer. In 2007, the U.S.

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Jul 18, 2015

Every health professional takes an oath to serve patients. To fulfill this covenant, patient trust must be earned. Without trust, patients are unlikely to share sensitive, personal information, hindering our ability to provide optimal care. Gaining trust is influenced by many factors. What influence does attire have on patients’ perceptions of their healthcare providers?

 

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Apr 3, 2014

Alzheimer Dementia (AD) is devastating and we need to start thinking outside the box with regard to treatment options. Currently available medications have only modest symptomatic benefits.1 Could something as widely available as vitamin E significantly alter the course of cognitive and functional decline invariable caused by AD?

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Feb 26, 2014

A simple fecal sample may be able to predict your patient’s risk for developing type 2 diabetes.  That’s right, not a blood test, but a STOOL test.   Our microbiome, the ecological community of microorganisms that share our bodies, influence our risk for disease.  And not just irritable bowel syndrome but many other diseases including type 2 diabetes, depression, cancer, asthma, psoriasis, and autism.1  Research regarding the connections between our microbiome and disease

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Feb 5, 2014

In the United States, nearly 70% of adults are overweight or obese.1  Excess adipose tissue increases the likelihood of developing sleep apnea, type 2 diabetes mellitus (T2DM), dyslipidemia, and hypertension. The rate of all-cause mortality in obese individuals is higher when compared to normal weight individuals.2 Its imperative that we address body weight with all patients in all health care settings – but particularly in primary care settings.

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Jun 14, 2013

Millions of Americans take a multivitamin daily. Millions do not. Should healthcare providers recommend a daily multivitamin to patients who do not already take one? Or discourage those who do?

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May 23, 2013

The World Health Organization (WHO) estimates that only 53% of pregnant women worldwide received any antiretrovirals during pregnancy to prevent mother-to-child HIV transmission in 2009.  In the absence of any intervention, the risk of transmission is high (upto 45%).1  Therefore it is crucial that infants born to previously untreated mothers receive postexposure prophylaxis.

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Mar 27, 2013

The CONQUER study was double-blind, placebo-controlled clinical trial that examined the potential benefits of the combination product Qsymia (phenterimine and topiramate) in patients who were overweight and obese.  Our moderator and panelists explore the findings of this study and how this new information should be applied to practice.

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Mar 29, 2012

Dronedarone (Multaq®), a guideline recommended drug therapy option for paroxysmal and persistent atrial fibrillation (AF), has failed to deliver on the initial hopes and hype as the safer alternative to amiodarone.  Recent studies have shown that dronedarone is associated with severe liver injury, pulmonary fibrosis, pneumonitis, as well as an increased risk of stroke and death.1-6 With the addition of a boxed warning prohibiting its use in patients with permanent AF, dronedarone m

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Dec 16, 2011

Clinicians trying to make decisions based on the current best evidence are faced with an overwhelming obstacle, Too Much Information (TMI)! With over 25,000 new randomized controlled trials published each year how can a provider critically appraise these studies, determine their internal and external validity, put these results into context with what is already known, and then make an informed decision?

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Oct 20, 2011

Do you tell your patients to take levothyroxine in the morning 30 to 60 minutes before food and at least 4 hours apart from other medications?  It is well known that many medications and foods influence the absorption and distribution of thyroxine (T4).  Morning administration of levothyroxine, before meals and other medications, is recommended by expert consensus and the package insert

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Oct 18, 2010

Non-alcoholic fatty liver disease (NAFLD) is a condition characterized by fat deposition in the hepatocytes of patients with minimal or no alcohol intake.  NAFLD has emerged as the leading cause of chronic liver disease in the Western world, with an estimated prevalence of 20-30% in the general population.1  Patients with NAFLD may present along spectrum of histological findings, ranging from simple hepatic steatosis (fat accumulation without inflammation or fibrosis) to nonalcoholic steatohe

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