The American journal of medicine
-
Patients with atrial fibrillation often have cardiovascular risk factors or known comorbid disease, yet the use of evidence-based primary and secondary prevention cardiac therapy among atrial fibrillation outpatients is unknown. ⋯ The majority of eligible atrial fibrillation outpatients did not receive all guideline-recommended therapies for cardiovascular comorbid conditions and risk factors. This represents a potential opportunity to improve atrial fibrillation patients' quality of care and outcomes.
-
Despite recent studies that suggested statins' beneficial effects on chronic obstructive pulmonary disease (COPD) outcomes, the impact, if any, of statins on COPD exacerbations remains unclear. This study aimed to examine the association between statin use and risk of hospitalized COPD exacerbation, and to assess whether the association varied by statin initiation, dose, or duration of use. ⋯ Statin use was associated with a reduced risk of COPD exacerbation, with a further risk reduction for statins prescribed more recently or at high doses.
-
Historical Article
Crooked path made straight: the rise and fall of the southern governors' plan to educate black physicians.
In 1945, a wave of GI-Bill-supported African American students, qualified for admission to medical schools, returned from their service in World War II. The possibility that their acceptance would integrate all-white medical schools was a problem for the southern governors. The governors responded with a carefully considered plan to shunt these African American applicants to historically black medical colleges by joining in a Compact and attempting to purchase Meharry Medical College in Nashville, Tennessee. This untold story of American medicine and its connection to our present shortage of African American physicians in the South needs to be remembered and passed on to future generations.
-
Addiction to prescription opioids is prevalent in primary care settings. Increasing prescription opioid use is largely responsible for a parallel increase in overdose nationally. Many patients most at risk for addiction and overdose come into regular contact with primary care providers. ⋯ Similarly, through the use of screening and brief interventions, patients with addiction can achieve improved health outcome. A spectrum of low-threshold care options can reduce the negative health consequences among individuals with opioid addiction. Screening in primary care coupled with short interventions, including motivational interviewing, syringe distribution, naloxone prescription for overdose prevention, and buprenorphine treatment are effective ways to manage addiction and its associated risks and improve health outcomes for individuals with opioid addiction.
-
Black pleural effusions are extremely rare and have been reported in patients with infection, malignancy, and hemorrhage. However, no review articles appear to have focused on this rare clinical presentation. ⋯ Black pleural effusions can be divided into 4 major categories based on the underlying pathophysiological conditions.