The American journal of medicine
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Recent allegations of fraud committed by one of the most prolific researchers in perioperative medicine, Don Poldermans, have left many clinicians in a state of disbelief. With over 500 peer-reviewed publications, Poldermans heavily influenced the clinical practice of perioperative beta-blockers and statins in noncardiac surgery, shaping guidelines and national policies on the use of these treatments. The effects of fraud in perioperative medicine are particularly caustic owing to a profound domino effect. ⋯ Because research misconduct in perioperative medicine can be so damaging, we present strategies to prevent such events in the future. Without such reform, fraud in research may very well continue. The price for such misconduct is simply too great to pay.
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Randomized Controlled Trial
Extended-release niacin acutely suppresses postprandial triglyceridemia.
Postprandial triglyceridemia predicts cardiovascular events. Niacin might lower postprandial triglycerides by restricting free fatty acids. Immediate-release niacin reduced postprandial triglycerides, but extended-release niacin failed to do so when dosed the night before a fat challenge. The study aims were to determine whether extended-release niacin dosed before a fat challenge suppresses postprandial triglycerides and whether postprandial triglycerides are related to free fatty acid restriction. ⋯ Given right before a fat meal, even a single dose of extended-release niacin suppresses postprandial triglyceridemia. This establishes that postprandial triglycerides suppression is an acute pharmacodynamic effect of extended-release niacin, probably the result of marked free fatty acid restriction. Further study is warranted to determine whether mealtime dosing would augment the clinical efficacy of extended-release niacin therapy.
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The inflammatory state of atherosclerosis has been established as those with chronic inflammatory diseases, such as rheumatoid arthritis and systemic lupus erythematosus, who are at increased risk of coronary artery disease. A systematic search was conducted to retrieve high-quality, peer-reviewed studies of inflammatory bowel disease and coronary artery disease. Recent literature supports an association between inflammatory bowel disease and coronary artery disease. ⋯ Common cardiovascular drugs such as statins and angiotensin-converting enzyme inhibitors may have dual potential for controlling inflammatory bowel disease and preventing or treating coronary artery disease. Large, prospective, longitudinal studies can help to determine the true prevalence of coronary artery disease in this population and confirm risk factors. In the absence of such evidence, physicians should be cognizant of increased coronary artery disease risk in inflammatory bowel disease patients without traditional risk factors and consider primary preventive strategies.
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Clinical Trial
Hemodialysis-associated hemosiderosis in the era of erythropoiesis-stimulating agents: a MRI study.
Most dialysis patients receiving erythropoesis-stimulating agents (ESA) also receive parenteral iron supplementation. There are few data on the risk of hemosiderosis in this setting. ⋯ Most hemodialysis patients receiving ESA and intravenous iron supplementation have hepatic iron overload on MRI. These findings call for a revision of guidelines on iron therapy in this setting, especially regarding the amount of iron infused and noninvasive methods for monitoring iron stores.
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Our goal was to determine the association between random admission hyperglycemia and new diagnosis of diabetes after discharge in patients hospitalized with pneumonia. ⋯ Moderate-to-severe random hyperglycemia in pneumonia patients admitted to the hospital is strongly associated with new diagnosis of diabetes. Opportunistic evaluation for diabetes may be warranted in this group.