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ACC 2015

ACC 2015

New research was presented at ACC.15, the annual scientific sessions of the American College of Cardiology, from March 14 to 16 in San Diego. The features below highlight some of the studies that emerged from the conference. CPAP Decreases Acute HF Rehospitalization Rates The Particulars: Prior research has identified sleep-disordered breathing in heart failure (HF) as a significant risk factor for patients with different forms of HF that can impact clinical outcomes. However, data are lacking on whether compliance with continuous positive airway pressure (CPAP) treatment influences readmission rates among patients with acute HF and sleep apnea. Data Breakdown: Patients who had been hospitalized for HF and determined to have sleep apnea within 4 weeks of discharge were examined for a study. Among those who were compliant with their CPAP treatment, average pulmonary artery systolic pressure levels decreased, whereas non-compliant patients experienced an increase in these levels. The average number of rehospitalizations decreased by 0.8 visits from baseline to 6 months follow-up in the compliant group but increased by 1.1 visits in the non-compliant group. Take Home Pearl: Compliance with CPAP therapy appears to reduce 6-month readmission rates among patients with acute decompensated HF who are found to have sleep apnea shortly after being discharged from the hospital. Sedentary Behavior & Coronary Artery Calcification The Particulars: Physical activity has been shown to have multiple cardiovascular benefits in numerous studies, but no definitive relationship has been shown between physical activity and coronary artery calcification (CAC). Little is known about the relationship between sedentary behavior and CAC, independent of physical activity. Data Breakdown: For a study, researchers analyzed data on more...
Why Silicon Valley Should Embrace Doctors

Why Silicon Valley Should Embrace Doctors

Innovation in healthcare blazes past technological advances in many other sectors. Spending in healthcare far exceeds many other areas of our nation’s dollars. Many corporations, established and start-ups alike, exist to capture that momentum. While novel ideas seemingly flourish every day, rarely does it occur with the input of those on the front lines, doctors. The software and data healthcare businesses thrive, yet those using this technology are often unsatisfied with it. For months, doctors cried out against the EHR systems we use because we feel it impedes our workflow. Many of us supplicate the big data companies to listen to us. How can a product be successful if those using it are dissatisfied? While many of these companies succeed, their success depreciates because they have not captured their end users of their products. There has never been a greater need for technology and innovation in medicine than there is today. Doctors need new tools both in practice management and the practice of medicine. But these tools require input from doctors to be developed in the most useful and practical way. Without listening to the input of doctors, companies possess just another gadget they try to sell to us. “Without listening to the input of doctors, companies possess just another gadget they try to sell to us.” In my practice, I see sales representatives calling on me all the time. Often, the products proffered have some advantages, but the weaknesses appear as well. This fact prevents me from purchasing many new products on the market. If asked, I could readily explain how these products could be altered to achieve...
The Sensitive Subject of HIV Treatment Side Effects

The Sensitive Subject of HIV Treatment Side Effects

Antiretroviral therapy (ART) is essential to keeping HIV from replicating and further infecting CD4 lymphocytes. When taken as prescribed, these medications have significantly increased life expectancy over the past 25 years. HIV has shifted from being an infection with dire consequences to one that is considered a manageable, chronic condition when treated with ART. Dealing With Side Effects While the benefits of modern combination ART (cART) treatments have been well documented, so too have their potential to cause side effects. Some side effects are easily managed, but others—such as insomnia, gastrointestinal abnormalities, fatigue and rashes—can be much more severe for patients. Some may only be present during the first month or two of starting cART treatment while the body adapts to the medication. When side effects become too burdensome, adherence to cART regimens can diminish, leading to serious consequences and putting patients at risk for developing resistance to the components of cART. Poor adherence can also lead to ongoing replication of HIV and subsequent loss of CD4 lymphocytes. Patients may fail to notify their doctors when side effects become so severe that they stop taking their medications. To prevent this non-disclosure, it’s important to establish a clear line of communication as patients begin treatment. Patients should be instructed to be vigilant about any changes in their regular bodily functions and counseled to contact their physician immediately to determine if their treatment is causing any of these changes. Tackling That Sensitive Subject Whether they feel embarrassed or simply that it’s inappropriate, patients may avoid talking openly about side effects like diarrhea. With this in mind, there is an underscored importance...
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