Almond "Appetizer" Effect on Glucose Tolerance Test (GTT) Results.

Background: The extent to which glucose intolerance can be acutely improved with dietary modification is unclear. The purpose of this study was to test the effect of ingesting a low-calorie almond preload ("appetizer") 30 minutes before oral glucose tolerance testing in glucose-intolerant individuals without diabetes.

Methods: Twenty adults with prediabetes or isolated 1-hour glucose ≥160 mg/dL underwent 2 fasting oral glucose tolerance tests (GTTs)-1 standard GTT and 1 GTT 30 minutes after eating a half ounce (12) of dry-roasted almonds.

A breath of fresh air: A family ceremony.

Healing rituals and ceremonies are conducted with the hope of ushering a sick or impaired person back to wellness or preserving health against perceived threats (Burns, 1996). In medical settings, healing ceremonies can address biopsychosocial, existential, and spiritual aspects of difficult situations (Hammerschlag, 1989; Johnson, Feldman, Lubin, & Southwick, 1995; Mehl-Madrona, 1999). This article describes presents the case history of Lisa H.

Evolution of preprofessional pharmacy curricula.

Objectives: To examine changes in preprofessional pharmacy curricular requirements and trends, and determine rationales for and implications of modifications.

Methods: Prerequisite curricular requirements compiled between 2006 and 2011 from all doctor of pharmacy (PharmD) programs approved by the Accreditation Council of Pharmacy Education were reviewed to ascertain trends over the past 5 years. An online survey was conducted of 20 programs that required either 3 years of prerequisite courses or a bachelor's degree, and a random sample of 20 programs that required 2 years of prerequisites.

Proton pump inhibitor therapy associated with lower glycosylated hemoglobin levels in type 2 diabetes.

Introduction: Oral hypoglycemic medications sometimes do not control type 2 diabetes well. Proton pump inhibitors (PPIs) as adjunctive therapy might improve diabetes control through increasing serum gastrin and fasting insulin levels.

Methods: Electronic medical records in a family medicine residency program office practice were reviewed for 73 individuals with type 2 diabetes (not taking insulin), for whom PPIs were prescribed.

Promoting knowledge of statins in patients with low health literacy using an audio booklet.

Background: Statins are generally well tolerated and effective at reducing a patient's risk of both primary and secondary cardiovascular events. Many patients who would benefit from statin therapy either do not adhere to or stop taking their statin medication within the first year. We developed an audio booklet targeted to low health literacy patients to teach them about the benefits and risks of statins to help the patients adhere to their statin therapy.

P2Y₁₂ receptor inhibitors: integrating ticagrelor into the management of acute coronary syndrome.

Acute coronary syndrome (ACS) is a continuum of disease that includes non-ST-segment elevation ACS and ST-segment elevation myocardial infarction. The purpose of this article is to define the developing role of ticagrelor in ACS and compare it to currently available P2Y₁₂ receptor inhibitors. While clopidogrel remains the "workhorse" P2Y₁₂ receptor inhibitor for many patients with ACS and prasugrel has an established role in select situations, clinicians must now assimilate the evolving role of ticagrelor.

Antithrombotic therapy for the CardioWest temporary total artificial heart.

The CardioWest temporary total artificial heart serves as a viable bridge to orthotopic heart transplantation in patients who are experiencing end-stage refractory biventricular heart failure. This device is associated with a low, albeit still substantial, risk of thrombosis. Platelet interactions with artificial surfaces are complex and result in continuous activation of contact proteins despite therapeutic anticoagulation.

Intrapericardial triamcinolone for acute pericarditis after electrophysiologic procedures.

Purpose: The use of intrapericardial triamcinolone for acute pericarditis after electrophysiologic procedures in three patients is described.

Summary: Treatment for idiopathic pericarditis and viral pericarditis, which account for about 85% of cases, focuses on pain management and decreasing pericardial inflammation. This is oftentimes achieved with nonsteroidal antiinflammatory drugs (NSAIDs).

An advanced cardiovascular pharmacotherapy course blending online and face-to-face instruction.

Objective: To assess the effectiveness of online instruction in a cardiology pharmacotherapy elective.

Design: Eight drug-focused lectures and 6 introductory presentations were added to a cardiology pharmacotherapy course. Students completed an online quiz after each online drug-focused lecture and scores were compared to quizzes taken at the beginning and end of the course, as well as on a cardiology advanced pharmacy practice experience (APPE).

Cost-effectiveness analysis of anticoagulation strategies in non-ST-elevation acute coronary syndromes.

Background: Contemporary studies document the outcomes of unfractionated heparin (UFH), enoxaparin, fondaparinux, and bivalirudin in patients with non-ST-elevation acute coronary syndrome (NSTE-ACS). It remains unclear which anticoagulant regimen is the most cost-effective.

Objective: To perform a cost-effectiveness analysis comparing 4 anticoagulant regimens in NSTE-ACS.

Successful use and dosing of bivalirudin after temporary total artificial heart implantation: a case series.

The temporary total artificial heart (TAH-t) has emerged as an effective bridge to transplantation for individuals with biventricular failure. Implantation of a TAH-t creates a hypercoagulable state requiring a multidrug approach that includes low-dose unfractionated heparin (UFH) in order to minimize thromboembolism. A concern with UFH is the development of heparin-dependent antibodies, which develop in up to 50% of patients receiving the drug as part of cardiopulmonary bypass.

Preprocedural statin therapy in percutaneous coronary intervention.

Objective: To review the published literature regarding the effectiveness of preprocedural statin therapy for the prevention of cardiac events after percutaneous coronary intervention (PCI).

Data Sources: Searches of MEDLINE (1966-May 2007) and Cochrane Database (1993-May 2007) were conducted using the search terms statins, HMG-CoA reductase inhibitors, percutaneous coronary intervention, and myocardial necrosis. Limits included articles written in English with human subjects.

Pharmacotherapy implications of revised chronic heart failure guidelines.

Objective: To provide an overview of major drug therapy recommendations within recently revised chronic heart failure (CHF)guidelines.

Data Sources: Guideline statements and English-language articles from MEDLINE pertinent to CHF.

Study Selection And Data Extraction: Recently published guidelines from the American College of Cardiology (ACC)/American Heart Association (AHA) and the Heart Failure Society of America (HFSA) served as the focus of this review.

Drug therapy recommendations from the 2005 ACC/AHA guidelines for treatment of chronic heart failure.

Objective: To review and discuss key aspects of the drug therapy recommendations in the American College of Cardiology (ACC)/American Heart Association (AHA) 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure (HF) in the Adult.

Data Sources: Data were obtained from the ACC/AHA 2005 Guideline Update for Chronic HF. English-language clinical trials, observational studies, and pertinent review articles evaluating the pharmacotherapy of chronic HF were identified, based on MEDLINE searches through January 2006.

Outcomes associated with vasoactive therapy in patients with acute decompensated heart failure.

Study Objectives: To describe the clinical management of acute decompensated heart failure (ADHF) in patients receiving intravenous treatment with dobutamine, milrinone, or nesiritide, and to evaluate differences, based on treatment received, in the in-hospital mortality rate, length of stay (LOS), total health care costs, and 30-day hospital readmission rate.

Design: Retrospective cohort analysis.

Data Source: University HealthSystem Consortium (UHC) Clinical Database Pharmacy, a database with information from 32 academic hospitals.

Evolving role of vasopressin in the treatment of cardiac arrest.

Sudden cardiac arrest is a major public heath problem, affecting more than 450,000 individuals annually. Response time and the initiation of cardiopulmonary resuscitation (CPR) remain the most important factors determining successful revival. During resuscitation, sympathomimetics are given to enhance cerebral and coronary perfusion pressures in an attempt to achieve restoration of spontaneous circulation.

Cost-effectiveness analysis of antithrombotic therapy in nonurgent percutaneous coronary intervention.

Study Objective: To perform a cost-effectiveness analysis comparing three treatment approaches during nonurgent percutaneous coronary intervention (PCI): bivalirudin with provisional glycoprotein (GP) IIb-IIIa inhibitor therapy, unfractionated heparin (UFH) with eptifibatide, and UFH with abciximab.

Design: Literature-based decision model from an institutional perspective.

Data Source: Patient data from the Randomized Evaluation in PCI Linking Angiomax to Reduced Clinical Events (REPLACE)-2 study and three other randomized controlled trials that included UFH and routine GP IIb-IIIa inhibitor (eptifibatide or abciximab) therapy.

Chronic heart failure: developments and perspectives.

Objective: To describe the clinical presentation, diagnosis, and contemporary treatment of chronic heart failure (CHF) while emphasizing the important role of the pharmacist.

Data Sources: English-language articles from MEDLINE pertinent to CHF.

Study Selection And Data Extraction: All relevant publications addressing CHF management were considered, including prospective comparative trials, epidemiological studies, guideline statements, review articles, and editorials.

Family history of coronary heart disease: evidence-based applications.

Clinicians sometimes consider family history of CHD when evaluating CHD risk and deciding whether to prescribe a lipid medication. Most clinicians who take family history of CHD into account do so by categorically adjusting the aggressiveness of patient education and preventive medication recommendations (eg, from a low-key informational mode to a more direct influential or persuasive mode). Quantitative methods exist for taking into account any family history of CHD in parents and siblings, when estimating an individual's 10-year risk for a CHD event; at present, these methods are not readily available.

Phase IV trial evaluating the effectiveness and safety of dofetilide.

Background: Dofetilide gained Food and Drug Administration approval for persistent atrial fibrillation/flutter (AFF) based on 2 randomized, placebo-controlled, dose-ranging studies. Concerns of proarrhythmia have prompted the manufacturer to develop specific treatment guidelines.

Objective: To determine the effectiveness and safety of dofetilide in clinical practice as well as to ascertain whether clinicians are following established dosing guidelines.

Family-oriented cardiac risk estimator: a Java web-based applet.

We developed a Java applet that calculates four different estimates of a person's 10-year risk for heart attack: (1) Estimate based on Framingham equation (2) Framingham equation estimate modified by C-reactive protein (CRP) level (3) Framingham estimate modified by family history of heart disease in parents or siblings (4) Framingham estimate modified by both CRP and family heart disease history. This web-based, family-oriented cardiac risk estimator uniquely considers family history and CRP while estimating risk.

Clinical relevance and management of drug-related QT interval prolongation.

Much attention recently has focused on drugs that prolong the QT interval, potentially leading to fatal cardiac dysrhythmias (e.g., torsade de pointes).

Glycoprotein IIb/IIIa receptor inhibitors in percutaneous coronary intervention and acute coronary syndrome.

Objective: To review the contemporary role of the glycoprotein (GYP) IIb/IIIa receptor inhibitors abciximab, eptifibatide, and tirofiban in patients undergoing percutaneous coronary intervention (PCI) and those with an acute coronary syndrome (ACS), and to provide an algorithm based on currently available evidence for specific agents.

Data Sources: Primary articles were identified by a MEDLINE search (1966-January 2003); references cited in these articles provided additional resources.

Study Selection And Data Extraction: All of the articles identified from data sources were considered for relevant information; this article primarily addresses large, controlled or comparative studies, and meta-analyses.