Professional Preferences and Perceptions of Cardiology Among Internal Medicine Residents: Temporal Trends Over the Past Decade.

Importance: Internal medicine residents' professional development preferences were discordant with their perceptions of cardiology in a survey circulated a decade ago; no contemporary data exist. This information is important for effective recruitment and retention of a highly talented and diverse future cardiology workforce.

Objective: To identify residents' professional development preferences and cardiology perceptions, in relation to specialty choice, and compare the findings with those from a decade prior.

Chest Pain During Chemotherapy: A Case of Severe Myocardial Bridging.

A cancer patient presented with acute chest pain at rest 40 hours after IV fluorouracil infusion. Angiography showed evidence of myocardial bridging.

Trends in outpatient transthoracic echocardiography: impact of appropriateness criteria publication.

Background: The impact of the 2007 American College of Cardiology Foundation Transthoracic Echocardiography Appropriateness Criteria on trends in appropriateness is unknown. Therefore, we sought to identify the appropriateness of outpatient transthoracic echocardiography pre- and postpublication of this document.

Methods: The 2007 Appropriateness Criteria were used to classify outpatient echocardiographic studies at an academic medical center during October 2000 and October 2008.

Asking for help: internal medicine residents' use of a medical procedure service.

Background: Little is known about the professional help-seeking behavior of residents as they perform procedures in the hospital.

Objective: To determine when residents seek formal supervision to perform inpatient medical procedures.

Design: We conducted a prospective cohort study of resident physicians' use of formal supervision through a medical procedure service (MPS) for placing central venous catheters (CVCs) and performing thoracenteses.

Economic evaluation of bivalirudin with or without glycoprotein IIb/IIIa inhibition versus heparin with routine glycoprotein IIb/IIIa inhibition for early invasive management of acute coronary syndromes.

Objectives: The aim of this study was to determine the economic impact of several anticoagulation strategies for moderate- and high-risk non-ST-segment elevation acute coronary syndrome (NSTE-ACS) patients managed invasively.

Background: The ACUITY (Acute Catheterization and Urgent Intervention Triage Strategy) trial demonstrated that bivalirudin monotherapy yields similar rates of ischemic complications and less bleeding than regimens incorporating glycoprotein IIb/IIIa receptor inhibitors (GPI) for moderate- and high-risk NSTE-ACS.

Methods: In ACUITY, 7,851 U.

The value older women in an academic primary care practice place on preventive health care services: implications for counseling.

Purpose: We sought to determine how women aged 80 years or older value different preventive health measures compared to women aged 65 to 79 years.

Design And Methods: We surveyed 107 women aged 80 years or older and 93 women aged 65 to 79 years; we randomly selected all of them from a large academic primary care practice. We measured perceived importance and priority placed on different preventive health measures, including screening tests; counseling on healthy lifestyle and geriatric health issues; immunizations; and recommendations for over-the-counter prevention medications.

Preventive health care among older women in an academic primary care practice.

Purpose: We sought to examine the use of preventive health services among older women and to assess how age and illness burden influence care patterns.

Methods: The charts of 299 women aged > or =80 and 229 women aged 65-79 years who did not have dementia or terminal illness at 1 academic primary care practice in Boston were reviewed between July and December 2005 to determine receipt of screening tests (e.g.

Factors influencing elderly women's mammography screening decisions: implications for counseling.

Background: Although guidelines recommend that clinicians consider life expectancy before screening older women for breast cancer, many older women with limited life expectancies are screened. We aimed to identify factors important to mammography screening decisions among women aged 80 and older compared to women aged 65-79.

Methods: Telephone surveys of 107 women aged 80+ and 93 women aged 65-79 randomly selected from one academic primary care practice who were able to communicate in English (60% response rate).

Atrial fibrillation: modern concepts and management.

Atrial fibrillation (AF) is a common cardiac arrhythmia responsible for significant morbidity and mortality. In recent years, progress has been made in determining the genetic abnormalities that may lead to AF. New trials have shown that rate control and anticoagulation are acceptable as a primary treatment strategy in many patients who have a high risk of recurrence.

Physicians' attitudes and the use of oral anticoagulants: surveying the present and envisioning future.

Atrial fibrillation has the highest prevalence in the elderly. While the elderly are at the highest risk for stroke and would benefit the most from anticoagulation, they are also the least likely to receive anticoagulation. In a pooled analysis of the primary prevention trials, warfarin reduced stroke by 68% compared with placebo, and aspirin reduced stroke by 18%.