Scholars@Duke
Anthony Joseph Viera

Anthony Joseph Viera

Leonard J. & Margaret Goldwater Distinguished Professor of Family Medicine and Community Health
Family Medicine and Community Health
anthony.viera@duke.edu
CFM, Box 2914 DUMC, Durham, NC 27710
2200 West Main Street, Erwin Square, 4th Floor, Durham, NC 27705

Selected Publications

Use of Impedance Cardiography to Guide Blood Pressure Lowering Medication Selection: Systematic Review of Randomized Controlled Trials.

Journal Article Am J Hypertens · October 14, 2024 BACKGROUND: Blood pressure (BP) control can be difficult to attain due to multiple factors, including choosing and titrating antihypertensive medications. Measurement of hemodynamic parameters using impedance cardiography (ICG) at the point of care may all ... Full text Link to item Cite

The utility of home blood pressure load in predicting average self-measured blood pressure.

Journal Article J Hypertens · September 1, 2024 OBJECTIVES: Average values for self-measured blood pressure (SMBP) more accurately reflect a patient's risk of cardiovascular disease than do office measurements. Oftentimes, however, patients provide lists of individual home blood pressure (BP) measuremen ... Full text Link to item Cite

Association of cancer with the risk of developing hypertension.

Journal Article Eur Heart J Qual Care Clin Outcomes · May 22, 2024 BACKGROUND AND AIMS: Although the importance of hypertension in patients with cancer is widely recognized, little is known about the risk of developing hypertension in patients with a history of cancer. METHODS AND RESULTS: This retrospective observational ... Full text Link to item Cite

Cognitive behavior therapy for insomnia for untreated hypertension with comorbid insomnia disorder: The SLEEPRIGHT clinical trial.

Journal Article J Clin Hypertens (Greenwich) · April 2024 Insomnia and poor sleep are associated with an increased risk of developing cardiovascular disease (CVD) and its precursors, including hypertension. In 2022, the American Heart Association (AHA) added inadequate sleep to its list of health behaviors that i ... Full text Link to item Cite

Who chooses "healthy" meals? An analysis of lunchtime meal quality in a workplace cafeteria.

Journal Article BMC Public Health · March 29, 2024 BACKGROUND: The workplace can play an important role in shaping the eating behaviors of U.S. adults. Unfortunately, foods obtained in the workplace tend to be low in nutritional quality. Questions remain about the best way to approach the promotion of heal ... Full text Link to item Cite

Sex Differences in Receipt of Bystander Cardiopulmonary Resuscitation Considering Neighborhood Racial and Ethnic Composition.

Journal Article J Am Heart Assoc · March 5, 2024 BACKGROUND: Bystander cardiopulmonary resuscitation (B-CPR) and defibrillation for out-of-hospital cardiac arrest (OHCA) vary by sex, with women being less likely to receive these interventions in public. It is unknown whether sex differences persist when ... Full text Link to item Cite

Unlocking Cardiovascular Health.

Journal Article Prim Care · March 2024 Full text Link to item Cite

Race differences in ambulatory blood pressure monitoring parameters.

Journal Article Blood Press Monit · February 1, 2024 BACKGROUND: Mean systolic and diastolic blood pressure (SBP and DBP) on ambulatory blood pressure (BP) monitoring (ABPM) are higher among Black compared with White adults. With 48 to 72 BP measurements obtained over 24 h, ABPM can generate parameters other ... Full text Link to item Cite

Acute Coronary Syndrome: Diagnosis and Initial Management.

Journal Article Am Fam Physician · January 2024 Acute coronary syndrome (ACS) is defined as reduced blood flow to the coronary myocardium manifesting as ST-segment elevation myocardial infarction or non-ST-segment elevation ACS, which includes unstable angina and non-ST-segment elevation myocardial infa ... Open Access Link to item Cite

Renewing the dream.

Journal Article J Fam Pract · November 2023 Full text Link to item Cite

Use of Different Blood Pressure Thresholds to Reduce the Number of Home Blood Pressure Monitoring Days Needed for Detecting Hypertension.

Journal Article Hypertension · October 2023 BACKGROUND: Home blood pressure (BP) monitoring over a 7-day period is recommended to confirm the diagnosis of hypertension. METHODS: We determined upper and lower home BP thresholds with >90% positive predictive value and >90% negative predictive value us ... Full text Link to item Cite

Feeling salty about our sodium intake.

Journal Article J Fam Pract · October 2023 Full text Link to item Cite

Tools-and rules-to support behavior change.

Journal Article J Fam Pract · September 2023 Full text Link to item Cite

Racial difference in the association between non-alcoholic fatty liver disease and incident type 2 diabetes: findings from the CARDIA study.

Journal Article Diabetologia · July 2023 AIMS/HYPOTHESIS: Type 2 diabetes and non-alcoholic fatty liver disease (NAFLD) are prevalent diseases of metabolic origin. We examined the association between NAFLD and the development of type 2 diabetes among non-Asian adults, and whether the association ... Full text Link to item Cite

Just a simple country doctor.

Journal Article J Fam Pract · July 2023 Full text Link to item Cite

Impact of primary care usual provider type and provider interdependence on outcomes for patients with diabetes: a cohort study.

Conference BMJ Open Qual · June 2023 BACKGROUND: Interprofessional primary care (PC) teams are key to the provision of high-quality care. PC providers often 'share' patients (eg, a patient may see multiple providers in the same clinic), resulting in between-visit interdependence between provi ... Full text Link to item Cite

Seasonal variation in blood pressure control across US health systems.

Journal Article J Hypertens · May 1, 2023 OBJECTIVE: We aimed to characterize seasonal variation in US population-based blood pressure (BP) control and BP-related metrics and evaluate the association between outdoor temperature and BP control variation. METHODS: We queried electronic health record ... Full text Link to item Cite

Disruption in Blood Pressure Control With the COVID-19 Pandemic: The PCORnet Blood Pressure Control Laboratory.

Journal Article Mayo Clin Proc · May 2023 OBJECTIVE: To explore trends in blood pressure (BP) control before and during the COVID-19 pandemic. PATIENTS AND METHODS: Health systems participating in the National Patient-Centered Clinical Research Network (PCORnet) Blood Pressure Control Laboratory S ... Full text Link to item Cite

When is caring sharing? Primary care provider interdependence and continuity of care.

Journal Article JAAPA · January 1, 2023 Efforts to improve access to high-quality, efficient primary care have highlighted the need for team-based care. Most primary care teams are designed to maintain continuity of care between patients and primary care providers (PCPs), because continuity of c ... Full text Link to item Cite

Reduction in blood pressure for elevated blood pressure/stage 1 hypertension according to the American College of Cardiology/American Heart Association guideline and cardiovascular outcomes.

Journal Article Eur J Prev Cardiol · October 20, 2022 AIMS: Few studies have examined the relationship of blood pressure (BP) change in adults with elevated BP or stage 1 hypertension according to the American College of Cardiology (ACC)/American Heart Association (AHA) guideline with cardiovascular outcomes. ... Full text Link to item Cite

Acute Headache in Adults: A Diagnostic Approach.

Journal Article Am Fam Physician · September 2022 A detailed history and physical examination can distinguish between key features of a benign primary headache and concerning symptoms that warrant further evaluation for a secondary headache. Most headaches that are diagnosed in the primary care setting ar ... Link to item Cite

Cardiovascular Disease Prevention: Lifestyle Interventions for Primary Prevention.

Journal Article FP Essent · September 2022 The fact that up to one-third of the 800,000 yearly cardiovascular disease (CVD) deaths in the United States may be preventable by diet and physical activity makes a compelling case for lifestyle interventions as a primary prevention strategy. The U.S. Pre ... Link to item Cite

Cardiovascular Disease Prevention: Pharmacologic Prevention.

Journal Article FP Essent · September 2022 Several drugs have shown benefits in primary and secondary prevention of cardiovascular disease (CVD). Aspirin should be used routinely for the secondary prevention of CVD. Low-dose aspirin should not be used for the primary prevention of CVD in adults age ... Link to item Cite

Cardiovascular Disease Prevention: Risk Assessment.

Journal Article FP Essent · September 2022 As part of the approach to primary prevention of cardiovascular disease (CVD), adults should have their CVD risk estimated using a population-appropriate risk equation. In the United States, the atherosclerotic cardiovascular disease (ASCVD) pooled cohort ... Link to item Cite

Cardiovascular Disease Prevention: Prevention Through Control of Medical Risks.

Journal Article FP Essent · September 2022 Diabetes, hypertension, tobacco use, and obesity each substantially increases the risk of cardiovascular disease (CVD) and must be controlled as part of CVD prevention. Among patients with diabetes, the reduction of CVD risk from lower A1c goals must be ba ... Link to item Cite

Medication-Naïve Blood Pressure and Incident Cancers: Analysis of 2 Nationwide Population-Based Databases.

Journal Article Am J Hypertens · August 1, 2022 BACKGROUND: Results of preceding studies on the relationship between blood pressure (BP) and cancers have been confounded due to individuals taking antihypertensive medications or shared risk factors. We assessed whether medication-naïve high BP is a risk ... Full text Link to item Cite

Comparison of the association of masked hypertension defined by the 2017 ACC/AHA BP guideline versus the JNC7 guideline with left ventricular hypertrophy.

Journal Article J Hypertens · August 1, 2022 BACKGROUND: Compared with the Seventh Report of the Joint National Committee (JNC7), the 2017 American College of Cardiology/American Heart Association (ACC/AHA) blood pressure (BP) guideline uses lower BP thresholds to define hypertension and BP control. ... Full text Link to item Cite

Isolated Diastolic Hypertension and Risk of Cardiovascular Disease: Controversies in Hypertension - Pro Side of the Argument.

Journal Article Hypertension · August 2022 Isolated diastolic hypertension (IDH), defined as diastolic blood pressure in the hypertensive range but systolic blood pressure not in the hypertensive range, is not uncommon (<20%) among adults with hypertension. IDH often manifests in concurrence with o ... Full text Link to item Cite

Impact of Asleep and 24-Hour Blood Pressure Data on the Prevalence of Masked Hypertension by Race/Ethnicity.

Journal Article Am J Hypertens · July 1, 2022 BACKGROUND: We pooled ambulatory blood pressure monitoring data from 5 US studies, including the Jackson Heart Study (JHS), the Coronary Artery Risk Development in Young Adults (CARDIA) study, the Masked Hypertension Study, the Improving the Detection of H ... Full text Link to item Cite

Age-Dependent Relationship of Hypertension Subtypes With Incident Heart Failure.

Journal Article J Am Heart Assoc · May 3, 2022 Background The prevalence of hypertension subtypes changes with age. However, little is known regarding the age-dependent association of hypertension subtypes with incident heart failure (HF). Methods and Results We conducted an observational cohort study ... Full text Link to item Cite

Hypertension-or not? Looking beyond office BP readings.

Journal Article J Fam Pract · May 2022 Follow these strategies and tips for using home and 24-hour ambulatory measurements to more accurately assess a patient's blood pressure. ... Full text Link to item Cite

Hypertension-mediated organ damage in masked hypertension.

Journal Article J Hypertens · April 1, 2022 OBJECTIVES: Masked hypertension - a blood pressure (BP) phenotype characterized by a clinic BP in the normal range but elevated BP outside the office - is associated with early hypertension-mediated organ damage. This study examined early target organ mani ... Full text Link to item Cite

Teaming up in primary care: Membership boundaries, interdependence, and coordination.

Journal Article JAAPA · February 1, 2022 OBJECTIVE: Increased demand for quality primary care and value-based payment has prompted interest in implementing primary care teams. Evidence-based recommendations for implementing teams will be critical to successful PA participation. This study sought ... Full text Link to item Cite

Comparisons of Four Diet Quality Indexes to Define Single Meal Healthfulness.

Journal Article J Acad Nutr Diet · January 2022 BACKGROUND: Many dietary indexes exist to evaluate nutrition quality, but few specifically assess the quality of a single meal. OBJECTIVE: Our aim was to compare 4 different diet quality indexes in their ability to assess the nutrition quality of single me ... Full text Link to item Cite

Preventing Cognitive Decline.

Journal Article Am Fam Physician · January 1, 2022 Link to item Cite

Angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, and COVID-19-related outcomes: A patient-level analysis of the PCORnet blood pressure control lab.

Journal Article Am Heart J Plus · January 2022 SARS-CoV-2 accesses host cells via angiotensin-converting enzyme-2, which is also affected by commonly used angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs), raising concerns that ACEI or ARB exposure may portend di ... Full text Link to item Cite

Development of a Community Hospital Medicine Affiliated Inpatient Rotation for Family Medicine Residents-A Collaborative Success.

Journal Article J Community Hosp Intern Med Perspect · 2022 BACKGROUND: Hospitalists perform key roles as inpatient educators for family medicine residents. For the past decade, Duke University Family Medicine Residency Program had its inpatient family medicine resident rotation at non-Duke facilities. OBJECTIVE: T ... Full text Link to item Cite

Hypertension

Chapter · January 1, 2022 Hypertension, also referred to as high blood pressure (BP), is one of the most common conditions seen in adult primary care practices. In 2016, there were nearly 33 million visits to provider offices with essential hypertension as the principle diagnosis [ ... Full text Cite

Ischemic Heart Disease

Chapter · January 1, 2022 Ischemic heart disease (IHD) refers to the condition of inadequate blood supply to the myocardium. It is also commonly referred to as heart disease, coronary heart disease (CHD), or coronary artery disease (CAD). From 2013 to 2016, the total number of peop ... Full text Cite

Untreated Hypertension and Subsequent Incidence of Colorectal Cancer: Analysis of a Nationwide Epidemiological Database.

Journal Article Journal of the American Heart Association · November 2021 Background Studies of the association of hypertension with incident colorectal cancer (CRC) may have been confounded by including individuals taking antihypertensive medication, at high risk for CRC (ie, colorectal polyps and inflammatory bowel disease), o ... Full text Cite

Primary Care of Adult Patients After Stroke: A Scientific Statement From the American Heart Association/American Stroke Association.

Journal Article Stroke · August 2021 Primary care teams provide the majority of poststroke care. When optimally configured, these teams provide patient-centered care to prevent recurrent stroke, maximize function, prevent late complications, and optimize quality of life. Patient-centered prim ... Full text Link to item Cite

Does This Adult Patient Have Hypertension?: The Rational Clinical Examination Systematic Review.

Journal Article JAMA · July 27, 2021 IMPORTANCE: Office blood pressure (BP) measurements are not the most accurate method to diagnose hypertension. Home BP monitoring (HBPM) and 24-hour ambulatory BP monitoring (ABPM) are out-of-office alternatives, and ABPM is considered the reference standa ... Full text Link to item Cite

Promoting Exercise and Healthy Diet Among Primary Care Patients: Feasibility, Preliminary Outcomes, and Lessons Learned From a Pilot Trial With High Intensity Interval Exercise

Journal Article Frontiers in Sports and Active Living · July 16, 2021 Physical activity and healthy diet are recognized as effective approaches for disease prevention. Controlled laboratory clinical trials support these approaches, yet minimal data exists supporting implementation of exercise as medicine within a healthcare ... Full text Cite

A Primary Care Agenda for Brain Health: A Scientific Statement From the American Heart Association.

Journal Article Stroke · June 2021 A healthy brain is critical for living a longer and fuller life. The projected aging of the population, however, raises new challenges in maintaining quality of life. As we age, there is increasing compromise of neuronal activity that affects functions suc ... Full text Link to item Cite

Partnerships to Care for Our Patients and Communities During COVID-19.

Journal Article J Am Board Fam Med · 2021 The Coronavirus disease 2019 (COVID-19) pandemic forced not only rapid changes in how clinical care and educational programs are delivered but also challenged academic medical centers (AMCs) like never before. The pandemic made clear the need to have coord ... Full text Open Access Link to item Cite

Principles and Practice of College Health

Book · December 4, 2020 This unique and comprehensive title offers state-of-the-art guidance on all of the clinical principles and practices needed in providing optimal health and well-being services for college students. Designed for college health professionals and administrato ... Full text Cite

Preface

Book · December 4, 2020 Cite

Abstract 236: Gender Disparities in Bystander CPR and Defibrillation Persist in Black and Hispanic Neighborhoods in the US

Conference Circulation · November 17, 2020 Introduction: Bystander CPR (B-CPR) and defibrillation for sudden cardiac arrest (SCA) vary by gender with females being less likely to receive these interventions. Despite known differences by race a ... Full text Cite

Vascular α1-Adrenergic Receptor Responsiveness in Masked Hypertension.

Journal Article Am J Hypertens · August 4, 2020 BACKGROUND: Masked hypertension (nonhypertensive in the clinic setting but hypertensive outside the clinic during wakefulness) is characterized by increased blood pressure in response to physical and emotional stressors that activate the sympathetic nervou ... Full text Link to item Cite

Long-Term Blood Pressure Variability in Young Adulthood and Coronary Artery Calcium and Carotid Intima-Media Thickness in Midlife: The CARDIA Study.

Journal Article Hypertension · August 2020 Recent evidence links long-term (visit-to-visit) blood pressure (BP) variability to the risk of cardiovascular disease, independent of mean BP levels. Potential associations between long-term BP variability and cardiovascular disease risk may be reflected ... Full text Link to item Cite

Association Between Visit-to-Visit Blood Pressure Variability in Early Adulthood and Myocardial Structure and Function in Later Life.

Journal Article JAMA Cardiol · July 1, 2020 IMPORTANCE: Long-term blood pressure (BP) variability has emerged as a reproducible measure that is associated with heart failure independent of systemic BP. Visit-to-visit BP variability may be associated with the risk of heart failure early in the life c ... Full text Link to item Cite

A pragmatic randomized trial of cardiopulmonary resuscitation training for families of cardiac patients before hospital discharge using a mobile application.

Journal Article Resuscitation · July 2020 AIM OF THE STUDY: Since over 80% of sudden cardiac arrests occur in the home, cardiopulmonary resuscitation (CPR) training for family members of high-risk cardiac patients represents a promising intervention. The use of mobile application-based (mApp) CPR ... Full text Link to item Cite

Potential effect of different nutritional labels on food choices among mothers: a study protocol.

Journal Article BMC Public Health · March 6, 2020 BACKGROUND: The prevalence of non-communicable diseases (NCDs) is increasing in the world. Healthy food choice and adequate physical activity are key factors in preventing NCDs. Food labeling is a strategy that can inform consumers to choose healthier food ... Full text Link to item Cite

Abstract P173: The Impact of Asleep Blood Pressure on the Prevalence of Masked Hypertension by Race/ethnicity: Analysis of Pooled Population- and Community-based Studies

Conference Circulation · March 3, 2020 Introduction: Masked hypertension is defined as having hypertensive blood pressure (BP) outside of the office setting among adults with non-hypertensive BP when measured in the office. Some guidelines ... Full text Cite

Preface.

Book · December 2019 Full text Link to item Cite

Preface

Journal Article Primary Care - Clinics in Office Practice · December 1, 2019 Full text Cite

Physical activity calorie expenditure (PACE) labels in worksite cafeterias: effects on physical activity.

Journal Article BMC Public Health · November 29, 2019 BACKGROUND: Regular physical activity is an important component of healthy living and wellbeing. Current guidelines recommend that adults participate in at least 150 min of moderate or vigorous-intensity physical activity weekly. In spite of the benefits, ... Full text Link to item Cite

Measurement of Blood Pressure in Humans: A Scientific Statement From the American Heart Association.

Journal Article Hypertension · May 2019 The accurate measurement of blood pressure (BP) is essential for the diagnosis and management of hypertension. This article provides an updated American Heart Association scientific statement on BP measurement in humans. In the office setting, many oscillo ... Full text Link to item Cite

Effect of calories-only vs physical activity calorie expenditure labeling on lunch calories purchased in worksite cafeterias.

Journal Article BMC Public Health · January 23, 2019 BACKGROUND: Calorie labeling on restaurant menus is a public health strategy to guide consumer ordering behaviors, but effects on calories purchased have been minimal. Displaying labels communicating the physical activity required to burn calories may be a ... Full text Link to item Cite

Comparative Cost-Effectiveness of Clinic, Home, or Ambulatory Blood Pressure Measurement for Hypertension Diagnosis in US Adults.

Journal Article Hypertension · January 2019 Previous cost-effectiveness models found ambulatory blood pressure monitoring (ABPM) to be a favorable strategy to diagnose hypertension; however, they mostly focused on older adults with a positive clinic blood pressure (BP) screen. We evaluated the cost- ... Full text Link to item Cite

Diagnostic Thresholds for Blood Pressure Measured at Home in the Context of the 2017 Hypertension Guideline.

Journal Article Hypertension · December 2018 Most guidelines have recommended lower home blood pressure (BP) threshold when clinic BP threshold of 140/90 mm Hg is used for diagnosis of hypertension. However, home BP thresholds to define hypertension have never been determined in the general populatio ... Full text Link to item Cite

Association of Blood Pressure Classification in Young Adults Using the 2017 American College of Cardiology/American Heart Association Blood Pressure Guideline With Cardiovascular Events Later in Life.

Journal Article JAMA · November 6, 2018 IMPORTANCE: Little is known regarding the association between level of blood pressure (BP) in young adulthood and cardiovascular disease (CVD) events by middle age. OBJECTIVE: To assess whether young adults who developed hypertension, defined by the 2017 A ... Full text Link to item Cite

Use of Machine Learning on Contact Lens Sensor-Derived Parameters for the Diagnosis of Primary Open-angle Glaucoma.

Journal Article Am J Ophthalmol · October 2018 PURPOSE: To test the hypothesis that contact lens sensor (CLS)-based 24-hour profiles of ocular volume changes contain information complementary to intraocular pressure (IOP) to discriminate between primary open-angle glaucoma (POAG) and healthy (H) eyes. ... Full text Link to item Cite

Physical activity equivalent labeling vs. calorie labeling: a systematic review and meta-analysis.

Journal Article Int J Behav Nutr Phys Act · September 14, 2018 BACKGROUND: Many countries are trying to identify strategies to control obesity. Nutrition labeling is a policy that could lead to healthy food choices by providing information to consumers. Calorie labeling, for example, could lead to consumers choosing l ... Full text Link to item Cite

Peak lung function during young adulthood and future long-term blood pressure variability: The Coronary Artery Risk Development in Young Adults (CARDIA) study.

Journal Article Atherosclerosis · August 2018 BACKGROUND AND AIMS: Long-term blood pressure variability (BPV) is associated with cardiovascular events independent of mean blood pressure (BP); however, little is known about its predictors. METHODS: Using data from the CARDIA study, we investigated the ... Full text Link to item Cite

Primary prevention of chronic kidney disease through population-based strategies for blood pressure control: The ARIC study.

Journal Article J Clin Hypertens (Greenwich) · June 2018 While much of the chronic kidney disease (CKD) literature focuses on the role of blood pressure reduction in delaying CKD progression, little is known about the benefits of modest population-wide decrements in blood pressure on incident CKD. The authors us ... Full text Link to item Cite

Hypertension Update: Current Guidelines.

Journal Article FP Essent · June 2018 Hypertension affects at least 1 in 3 American adults and is a major contributor to premature mortality. Current guidelines recommend screening all adults for hypertension. Ambulatory blood pressure (BP) monitoring should be used to confirm the diagnosis of ... Link to item Cite

Hypertension Update: Older Adults.

Journal Article FP Essent · June 2018 Hypertension is prevalent in older adults, and blood pressure (BP) level lowering has been shown to be one of the most important clinical interventions to reduce the risk of cardiovascular events. The goal BP level for older adults is individualized based ... Link to item Cite

Hypertension Update: Hypertensive Emergency and Asymptomatic Severe Hypertension.

Journal Article FP Essent · June 2018 Hypertensive emergency occurs when the blood pressure (BP) level is severely elevated (ie, higher than 180 mm Hg systolic or higher than 120 mm Hg diastolic) and acute organ damage is present. Patients with hypertensive emergencies are treated initially in ... Link to item Cite

Hypertension Update: Resistant Hypertension.

Journal Article FP Essent · June 2018 Resistant hypertension is a blood pressure (BP) level that remains above the goal level despite adherence to at least three appropriately dosed antihypertensive drugs of different classes, one of which is a diuretic. Evaluation of suspected resistant hyper ... Link to item Cite

Workplace health and safety intervention for child care staff: Rationale, design, and baseline results from the CARE cluster randomized control trial.

Journal Article Contemp Clin Trials · May 2018 BACKGROUND: Low-wage workers suffer disproportionately high rates of chronic disease and are important targets for workplace health and safety interventions. Child care centers offer an ideal opportunity to reach some of the lowest paid workers, but these ... Full text Link to item Cite

Implementing ABPM into Clinical Practice.

Journal Article Curr Hypertens Rep · February 5, 2018 PURPOSE OF REVIEW: To review the data supporting the use of ambulatory blood pressure monitoring (ABPM), and to provide practical guidance for practitioners who are establishing an ambulatory monitoring service. RECENT FINDINGS: ABPM results more accuratel ... Full text Link to item Cite

Association of ambulatory blood pressure variability with coronary artery calcium.

Journal Article J Clin Hypertens (Greenwich) · February 2018 Blood pressure (BP) variability is associated with progression to clinical atherosclerosis. The evidence is inconclusive if BP variability predicts cardiovascular outcomes in low-risk populations. The aim of this study was to analyze the association of 24- ... Full text Link to item Cite

Same Content, Different Methods: Comparing Lecture, Engaged Classroom, and Simulation.

Journal Article Fam Med · February 2018 BACKGROUND AND OBJECTIVES: There is a push to use classroom technology and active teaching methods to replace didactic lectures as the most prevalent format for resident education. This multisite collaborative cohort study involving nine residency programs ... Full text Link to item Cite

Identifying and describing segments of office workers by activity patterns: Associations with demographic characteristics and objectively measured physical activity

Journal Article International Journal of Workplace Health Management · January 1, 2018 Purpose - The purpose of this paper is to identify and characterize patterns of physical activity among office workers employed in largely sedentary occupations at a major health insurer located in the Southeastern USA. Design/methodology/approach - The au ... Full text Cite

Using the theory of planned behavior to explain intention to eat a healthful diet among Southeastern United States office workers

Journal Article Nutrition and Food Science · January 1, 2018 Purpose: This study aims to test the utility of the theory of planned behavior (TPB) for explaining intention to eat a healthful diet in a sample of Southeastern US office workers. Design/methodology/approach: Participants in a worksite nutrition study (n ... Full text Cite

Continuing Medical Education and Firearm Violence Counseling.

Journal Article AMA J Ethics · January 1, 2018 Firearm violence is a significant and increasing cause of mortality. Although physicians view firearm counseling as their professional obligation, few engage in the practice. This study examines medical education and firearm counseling among physicians in ... Full text Link to item Cite

Visit-to-Visit Blood Pressure Variability in Young Adulthood and Hippocampal Volume and Integrity at Middle Age: The CARDIA Study (Coronary Artery Risk Development in Young Adults).

Journal Article Hypertension · December 2017 The aims of this study are to assess the relationships of visit-to-visit blood pressure (BP) variability in young adulthood to hippocampal volume and integrity at middle age. We used data over 8 examinations spanning 25 years collected in the CARDIA study ... Full text Link to item Cite

Utilization of Standard and Target-Specific Oral Anticoagulants Among Adults in the United Kingdom With Incident Atrial Fibrillation.

Journal Article Am J Cardiol · November 15, 2017 New oral anticoagulants (OACs) and updated risk stratification have the potential to improve the quality of care for patients with atrial fibrillation (AF). To describe the time from AF diagnosis to the initiation of an OAC, characteristics associated with ... Full text Link to item Cite

The Reproducibility of Racial Differences in Ambulatory Blood Pressure Phenotypes and Measurements.

Journal Article Am J Hypertens · October 1, 2017 BACKGROUND: We examined the reproducibility of differences in ambulatory blood pressure (BP) monitoring (ABPM) phenotypes and other parameters (sustained hypertension, masked hypertension, nocturnal hypertension, and nondipping) between African Americans a ... Full text Link to item Cite

Patients' confidence in methods of blood pressure assessment and their reported adherence to antihypertensive medications.

Journal Article Blood Press Monit · October 2017 OBJECTIVE: Adherence to antihypertensive medications is often less than optimal. Research suggests that patients have limited confidence regarding whether office blood pressure (BP) assessments represent their 'true' BP, which may further promote poor adhe ... Full text Link to item Cite

Effects of physical activity calorie expenditure (PACE) labeling: study design and baseline sample characteristics.

Journal Article BMC Public Health · September 12, 2017 BACKGROUND: Obesity and physical inactivity are responsible for more than 365,000 deaths per year and contribute substantially to rising healthcare costs in the US, making clear the need for effective public health interventions. Calorie labeling on menus ... Full text Link to item Cite

Geographic Information Systems Mapping of Diabetic Retinopathy in an Ocular Telemedicine Network.

Journal Article JAMA Ophthalmol · July 1, 2017 IMPORTANCE: Minimal information exists on the use of geographic information systems mapping for visualizing access barriers to eye care for patients with diabetes. OBJECTIVE: To use geographic information systems mapping techniques to visualize (1) the loc ... Full text Link to item Cite

Screening for Hypertension and Lowering Blood Pressure for Prevention of Cardiovascular Disease Events.

Journal Article Med Clin North Am · July 2017 Hypertension affects 1 in 3 American adults. Blood pressure (BP)-lowering therapy reduces the risk of cardiovascular disease. The United States Preventive Services Task Force recommends all adults be screened for hypertension. Most patients whose office BP ... Full text Link to item Cite

Evaluation of Diabetic Retinal Screening and Factors for Ophthalmology Referral in a Telemedicine Network.

Journal Article JAMA Ophthalmol · July 1, 2017 IMPORTANCE: Retinal telescreening for evaluation of diabetic retinopathy (DR) in the primary care setting may be useful in reaching rural and underserved patients. OBJECTIVES: To evaluate telemedicine retinal screenings for patients with type 1 or 2 diabet ... Full text Link to item Cite

Use of the 5 As for Teen Alcohol Use.

Journal Article Clin Pediatr (Phila) · May 2017 Clinical guidelines recommend addressing adolescent alcohol use in primary care; the 5 As (Ask, Advise, Assess, Assist, Arrange) may be a useful model for intervention. We audio-recorded 540 visits with 49 physicians and adolescents, compared alcohol discl ... Full text Link to item Cite

Associations of Blood Pressure Dipping Patterns With Left Ventricular Mass and Left Ventricular Hypertrophy in Blacks: The Jackson Heart Study.

Journal Article J Am Heart Assoc · April 5, 2017 BACKGROUND: Abnormal diurnal blood pressure (BP), including nondipping patterns, assessed using ambulatory BP monitoring, have been associated with increased cardiovascular risk among white and Asian adults. We examined the associations of BP dipping patte ... Full text Link to item Cite

Whatever happened to the polypill?

Journal Article BMJ · March 27, 2017 Full text Link to item Cite

Blood pressure-associated polymorphism controls ARHGAP42 expression via serum response factor DNA binding.

Journal Article J Clin Invest · February 1, 2017 We recently demonstrated that selective expression of the Rho GTPase-activating protein ARHGAP42 in smooth muscle cells (SMCs) controls blood pressure by inhibiting RhoA-dependent contractility, providing a mechanism for the blood pressure-associated locus ... Full text Link to item Cite

AMBULATORY BLOOD PRESSURE PATTERNS IN PATIENTS WITH RETINAL VEIN OCCLUSION.

Journal Article Retina · December 2016 PURPOSE: Failure of blood pressure (BP) to dip during sleep (nondipper pattern) is associated with cardiovascular disease and stroke. The prevalence and degree of nondipping and masked hypertension in patients with retinal vein occlusion (RVO), which is as ... Full text Link to item Cite

Is frequency of fast food and sit-down restaurant eating occasions differentially associated with less healthful eating habits?

Journal Article Preventive Medicine Reports · December 1, 2016 Studies have shown that frequency of fast food restaurant eating and sit-down restaurant eating is differentially associated with nutrient intakes and biometric outcomes. The objective of this study was to examine whether frequency of fast food and sit-dow ... Full text Cite

Management of mild hypertension in adults.

Journal Article BMJ · November 21, 2016 Elevated blood pressure is a common risk factor for cardiovascular disease and affects one in three adults. Blood pressure lowering drugs substantially reduce the risk of stroke, coronary heart disease, heart failure, and premature death, but most clinical ... Full text Link to item Cite

Community-Acquired Pneumonia in Adults: Diagnosis and Management.

Journal Article Am Fam Physician · November 1, 2016 Community-acquired pneumonia is a leading cause of death. Risk factors include older age and medical comorbidities. Diagnosis is suggested by a history of cough, dyspnea, pleuritic pain, or acute functional or cognitive decline, with abnormal vital signs ( ... Link to item Cite

Evaluation of Criteria to Detect Masked Hypertension.

Journal Article J Clin Hypertens (Greenwich) · November 2016 The prevalence of masked hypertension (out-of-clinic daytime systolic/diastolic blood pressure (SBP/DBP) ≥135/85 mm Hg on ambulatory blood pressure monitoring [ABPM] among adults with clinic SBP/DBP <140/90 mm Hg) is high. It is unclear who should be scree ... Full text Link to item Cite

Examination of Several Physiological and Psychosocial Factors Potentially Associated With Masked Hypertension Among Low-Risk Adults.

Journal Article J Clin Hypertens (Greenwich) · August 2016 The authors examined the association of factors, in addition to prehypertensive office blood pressure (BP) level, that might improve detection of masked hypertension (MH), defined as nonelevated office BP with elevated out-of-office BP average, among indiv ... Full text Link to item Cite

Visit-to-Visit Variability in Blood Pressure Is Related to Late-Life Cognitive Decline.

Journal Article Hypertension (Dallas, Tex. : 1979) · July 2016 The association between visit-to-visit variability of blood pressure (BP) and cognitive decline over time remains incompletely understood in a general population of older adults. We assessed the hypothesis that higher visit-to-visit variability in BP, but ... Full text Cite

Masked Hypertension and Incident Clinic Hypertension Among Blacks in the Jackson Heart Study.

Journal Article Hypertension · July 2016 Masked hypertension, defined as nonelevated clinic blood pressure (BP) and elevated out-of-clinic BP may be an intermediary stage in the progression from normotension to hypertension. We examined the associations of out-of-clinic BP and masked hypertension ... Full text Link to item Cite

Was This Readmission Preventable? Qualitative Study of Patient and Provider Perceptions of Readmissions.

Journal Article South Med J · June 2016 OBJECTIVES: Readmissions are a costly, burdensome, and potentially preventable occurrence in the healthcare system. With the renewed national focus on the cost and quality of health care, readmissions have become a major target for improvement; however, in ... Full text Link to item Cite

Longitudinal Patterns of Change in Systolic Blood Pressure and Incidence of Cardiovascular Disease: The Atherosclerosis Risk in Communities Study.

Journal Article Hypertension · June 2016 Elevated blood pressure in midlife contributes significantly to the risk of cardiovascular disease. However, patterns of blood pressure increase may differ among individuals and may result in differential risk. Our goal was to examine the contribution of l ... Full text Link to item Cite

Dollars and Discomfort: What Will People Be Willing to Give for Better Blood Pressure Assessment?

Journal Article J Clin Hypertens (Greenwich) · May 2016 Recently, the US Preventive Services Task Force issued a draft recommendation to utilize 24-hour ambulatory blood pressure (BP) monitoring (ABPM) to confirm the diagnosis of hypertension after screening. However, ABPM can be inconvenient and has some adver ... Full text Link to item Cite

The leadership stance

Chapter · March 18, 2016 Full text Cite

Managing your time

Chapter · March 18, 2016 Full text Cite

Management and leadership skills for medical faculty: A practical handbook

Book · March 18, 2016 Recognizing that medical faculty face different questions or issues in different stages of their careers, this handy, practical title offers a comprehensive roadmap and range of solutions to common challenges in the complex and changing Academic Medical Ce ... Full text Cite

Cross-sectional survey of Good Samaritan behaviour by physicians in North Carolina.

Journal Article BMJ Open · March 10, 2016 OBJECTIVE: To assess the responses of physicians to providing emergency medical assistance outside of routine clinical care. We assessed the percentage who reported previous Good Samaritan behaviour, their responses to hypothetical situations, their comfor ... Full text Link to item Cite

Differences in night-time and daytime ambulatory blood pressure when diurnal periods are defined by self-report, fixed-times, and actigraphy: Improving the Detection of Hypertension study.

Journal Article J Hypertens · February 2016 OBJECTIVES: To determine whether defining diurnal periods by self-report, fixed-time, or actigraphy produce different estimates of night-time and daytime ambulatory blood pressure (ABP). METHODS: Over a median of 28 days, 330 participants completed two 24- ... Full text Link to item Cite

Ischemic heart disease

Chapter · January 1, 2016 Ischemic heart disease (IHD) refers to the condition of inadequate blood supply to the myocardium. It is also commonly referred to as coronary heart disease or coronary artery disease. Each year about 600,000 Americans have their first myocardial infarctio ... Full text Cite

Hypertension

Chapter · January 1, 2016 Hypertension is the most commonly seen condition in adult primary care practices. It affects one in three American adults over the age of 18, with women and men being nearly equally affected [1]. Data from the Framingham Heart Study have shown that patient ... Full text Cite

Interactive media for parental education on managing children chronic condition: a systematic review of the literature.

Journal Article BMC Pediatr · December 3, 2015 BACKGROUND: Although some research has examined the use of games for the education of pediatric patients, the use of technology for parental education seems like an appropriate application as it has been a part of the popular culture for at least 30 years. ... Full text Link to item Cite

Caterpillar cereal as a potential complementary feeding product for infants and young children: nutritional content and acceptability.

Journal Article Matern Child Nutr · December 2015 Micronutrient deficiency is an important cause of growth stunting. To avoid micronutrient deficiency, the World Health Organization recommends complementary feeding with animal-source foods. However, animal-source foods are not readily available in many pa ... Full text Link to item Cite

Comparison of patients' confidence in office, ambulatory, and home blood pressure measurements as methods of assessing for hypertension.

Conference Blood Press Monit · December 2015 OBJECTIVE: Uncertainty exists when relying on office (clinic) blood pressure (BP) measurements to diagnose hypertension. Home BP monitoring and ambulatory BP monitoring (ABPM) provide measurements that are more strongly associated with cardiovascular disea ... Full text Link to item Cite

Nocturnal Blood Pressure in Young Adults and Cognitive Function in Midlife: The Coronary Artery Risk Development in Young Adults (CARDIA) Study.

Journal Article Am J Hypertens · October 2015 BACKGROUND: Nocturnal blood pressure (BP) is associated with risk for cardiovascular events. However, the relationship between nocturnal BP in young adults and cognitive function in midlife remains unclear. METHODS: We used data from the ambulatory BP moni ... Full text Link to item Cite

Different Measures, Different Outcomes? A Systematic Review of Performance-Based versus Self-Reported Measures of Health Literacy and Numeracy.

Journal Article J Gen Intern Med · October 2015 BACKGROUND: Health literacy (HL) and numeracy are measured by one of two methods: performance on objective tests or self-report of one's skills. Whether results from these methods differ in their relationship to health outcomes or use of health services is ... Full text Link to item Cite

Potassium Disorders: Hypokalemia and Hyperkalemia.

Journal Article Am Fam Physician · September 15, 2015 Hypokalemia and hyperkalemia are common electrolyte disorders caused by changes in potassium intake, altered excretion, or transcellular shifts. Diuretic use and gastrointestinal losses are common causes of hypokalemia, whereas kidney disease, hyperglycemi ... Link to item Cite

A case of atypical Bartonella henselae infection in a patient with methimazole-induced agranulocytosis.

Journal Article BMJ Case Rep · August 27, 2015 Antithyroid medications such as methimazole and propylthiouracil are commonly used to treat hyperthyroid disorders. Thionamide-induced agranulocytosis is a rare but life-threatening potential side effect of these medicines. In addition to routine monitorin ... Full text Link to item Cite

Physician Beliefs about Physical and Mental Competency of Patients Applying for Concealed Weapon Permits.

Journal Article Behav Sci Law · June 2015 Law enforcement officials have asked health care providers to evaluate patient applications for concealed weapon permits. The current study was designed to examine physician beliefs regarding competency to carry a concealed weapon for patients with specifi ... Full text Link to item Cite

Resident involvement and experience do not affect perioperative complications following robotic prostatectomy.

Journal Article World J Urol · June 2015 PURPOSE: Most urologic training programs use robotic prostatectomy (RP) as an introduction to teach residents appropriate robotic technique. However, concerns may exist regarding differences in RP outcomes with resident involvement. Our objective was there ... Full text Link to item Cite

Quantifying the utility of taking pills for preventing adverse health outcomes: a cross-sectional survey.

Journal Article BMJ Open · May 11, 2015 OBJECTIVES: The utility value attributed to taking pills for prevention can have a major effect on the cost-effectiveness of interventions, but few published studies have systematically quantified this value. We sought to quantify the utility value of taki ... Full text Open Access Link to item Cite

Racial differences in abnormal ambulatory blood pressure monitoring measures: Results from the Coronary Artery Risk Development in Young Adults (CARDIA) study.

Journal Article Am J Hypertens · May 2015 BACKGROUND: Several ambulatory blood pressure monitoring (ABPM) measures have been associated with increased cardiovascular disease risk independent of clinic blood pressure (BP). African Americans have higher clinic BP compared with Whites but few data ar ... Full text Link to item Cite

Quantifying the utility of taking pills for cardiovascular prevention.

Journal Article Circ Cardiovasc Qual Outcomes · March 2015 BACKGROUND: The decrease in utility attributed to taking pills for cardiovascular prevention can have major effects on the cost-effectiveness of interventions but has not been well studied. We sought to measure the utility of daily pill-taking for cardiova ... Full text Link to item Cite

Potential effect of physical activity calorie equivalent labeling on parent fast food decisions.

Journal Article Pediatrics · February 2015 OBJECTIVES: Menu labels displaying food energy in physical activity calorie equivalents (PACE) is a possible strategy to encourage ordering meals with fewer calories and promoting physical activity. Potential effects of such labeling for children have neve ... Full text Link to item Cite

Text messaging to improve resident knowledge: a randomized controlled trial.

Journal Article Fam Med · January 2015 BACKGROUND AND OBJECTIVES: Advances in technology present opportunities to develop and test innovative teaching methods. We sought to evaluate whether text messaging could improve medical resident knowledge in musculoskeletal medicine. METHODS: Eleven U.S. ... Link to item Cite

Resistant hypertension: Definition, prevalence, and therapeutic approaches

Chapter · January 1, 2015 Resistant hypertension (RH) is defined as blood pressure (BP) above goal despite adherence to at least three optimally dosed antihypertensive medications of different classes, one of which is a diuretic. Not all patients with BP that is difficult to contro ... Full text Cite

Potential Effect of Physical Activity Calorie Equivalent (PACE) Labeling on Adult Fast Food Ordering and Exercise.

Journal Article PLoS One · 2015 INTRODUCTION: Numeric calorie content labels show limited efficacy in reducing the number of calories ordered from fast food meals. Physical activity calorie equivalent (PACE) labels are an alternative that may reduce the number of calories ordered in fast ... Full text Link to item Cite

Plasma renin testing to guide antihypertensive therapy.

Journal Article Curr Hypertens Rep · January 2015 Plasma renin activity (PRA)-guided therapy has been proposed as a strategy for selecting antihypertensive medications matched to the patient's underlying pathophysiology. To date, there are only a few studies that have sought to compare a PRA-guided strate ... Full text Link to item Cite

Diagnosis and management of acute coronary syndrome: an evidence-based update.

Journal Article J Am Board Fam Med · 2015 Acute coronary syndrome (ACS) describes the range of myocardial ischemic states that includes unstable angina, non-ST elevated myocardial infarction (MI), or ST-elevated MI. ACS is associated with substantial morbidity and mortality and places a large fina ... Full text Link to item Cite

Comparison of brief health literacy screens in the emergency department.

Journal Article J Health Commun · 2015 Measuring health literacy efficiently yet accurately is of interest both clinically and in research. The authors examined 6 brief health literacy measures and compared their categorization of patient health literacy levels and their comparative association ... Full text Link to item Cite

Ambulatory blood pressure monitoring in clinical practice: a review.

Journal Article Am J Med · January 2015 Ambulatory blood pressure monitoring offers the ability to collect blood pressure readings several times an hour across a 24-hour period. Ambulatory blood pressure monitoring facilitates the identification of white-coat hypertension, the phenomenon whereby ... Full text Link to item Cite

Levels of office blood pressure and their operating characteristics for detecting masked hypertension based on ambulatory blood pressure monitoring.

Journal Article Am J Hypertens · January 2015 BACKGROUND: Masked hypertension (MH)--nonelevated office blood pressure (BP) with elevated out-of-office BP average--conveys cardiovascular risk similar to or approaching sustained hypertension, making its detection of potential clinical importance. Howeve ... Full text Link to item Cite

The effect of numeracy level on completeness of home blood pressure monitoring.

Journal Article J Clin Hypertens (Greenwich) · January 2015 Home blood pressure monitoring (HBPM) readings predict the increased risks of cardiovascular events and end-organ damage independent of office blood pressure (BP). Numeracy (the ability to handle numbers) may limit the feasibility of patients' performing H ... Full text Link to item Cite

The use of ambulatory blood pressure monitoring among Medicare beneficiaries in 2007-2010.

Journal Article J Am Soc Hypertens · December 2014 The US Centers for Medicaid and Medicare Services reimburses ambulatory blood pressure monitoring (ABPM) for suspected white coat hypertension. We estimated ABPM use between 2007 and 2010 among a 5% random sample of Medicare beneficiaries (≥65 years). In 2 ... Full text Link to item Cite

Rates, amounts, and determinants of ambulatory blood pressure monitoring claim reimbursements among Medicare beneficiaries.

Journal Article J Am Soc Hypertens · December 2014 Ambulatory blood pressure monitoring (ABPM) can be used to identify white coat hypertension and guide hypertensive treatment. We determined the percentage of ABPM claims submitted between 2007 and 2010 that were reimbursed. Among 1970 Medicare beneficiarie ... Full text Link to item Cite

Staying ahead of pertussis.

Journal Article J Fam Pract · November 2014 In recent years, pertussis has been on the rise. Here's what you can do to help limit the spread of the disease, and how to promptly diagnose and treat it. ... Link to item Cite

Ambulatory blood pressure phenotypes and the risk for hypertension.

Journal Article Curr Hypertens Rep · October 2014 Ambulatory blood pressure (BP) monitoring provides valuable information on a person's BP phenotype. Abnormal ambulatory BP phenotypes include white-coat hypertension, masked hypertension, nocturnal nondipping, nocturnal hypertension, and high BP variabilit ... Full text Link to item Cite

Unmasking masked hypertension: prevalence, clinical implications, diagnosis, correlates and future directions.

Journal Article J Hum Hypertens · September 2014 'Masked hypertension' is defined as having non-elevated clinic blood pressure (BP) with elevated out-of-clinic average BP, typically determined by ambulatory BP monitoring. Approximately 15-30% of adults with non-elevated clinic BP have masked hypertension ... Full text Link to item Cite

Immigrant and refugee health: common infectious diseases.

Journal Article FP Essent · August 2014 Immigrants and refugees are at risk of infectious diseases (IDs) that are rare in the United States. Screening and treatment before entry into the United States are required for some of these diseases, whereas quarantine is mandated for others. The Centers ... Link to item Cite

Immigrant and refugee health: cross-cultural communication.

Journal Article FP Essent · August 2014 Physicians in the United States increasingly care for culturally, linguistically, and educationally diverse immigrants with limited English proficiency. Language barriers contribute significantly to the health disparities experienced by patients with limit ... Link to item Cite

Immigrant and refugee health: mental health conditions.

Journal Article FP Essent · August 2014 Immigrants leave their homes for unfamiliar destinations in search of better lives for themselves and their families. Many immigrants experience profound loss and emotional distress as they adjust to life in different societies. Despite these challenges, t ... Link to item Cite

Reproducibility of masked hypertension among adults 30 years or older.

Journal Article Blood Press Monit · August 2014 OBJECTIVE: Masked hypertension (MH) refers to nonelevated office blood pressure (BP) with elevated out-of-office BP, but its reproducibility has not been conclusively established. We examined 1-week reproducibility of MH by home BP monitoring (HBPM) and am ... Full text Link to item Cite

Anticoagulation: managing adverse events in patients receiving anticoagulation and perioperative care.

Journal Article FP Essent · July 2014 When patients present with major or life-threatening bleeding due to warfarin use, rapid reversal with coagulation factors and vitamin K often is warranted. Oral vitamin K should be administered if the international normalized ratio is greater than 10 with ... Link to item Cite

Anticoagulation: monitoring of patients receiving anticoagulation.

Journal Article FP Essent · July 2014 For patients with acute venous thromboembolism treated with warfarin, parenteral anticoagulation should be continued for a minimum of 5 days and until the international normalized ratio (INR) is 2 or greater for at least 24 hours. Early initiation of warfa ... Link to item Cite

Anticoagulation: indications and risk classification schemes.

Journal Article FP Essent · July 2014 Anticoagulation is an important component of the management strategy for several common medical conditions. It is indicated for the prevention of recurrent thrombosis in patients with venous thromboembolism (VTE), which includes deep venous thrombosis and ... Link to item Cite

Anticoagulation: choosing the optimal anticoagulant.

Journal Article FP Essent · July 2014 The risks of bleeding and thrombosis should be considered in decisions on whether to initiate anticoagulation therapy. Oral anticoagulation is indicated for patients with nonvalvular atrial fibrillation who are at intermediate or high risk of stroke (CHADS ... Link to item Cite

Leukemia: an overview for primary care.

Journal Article Am Fam Physician · May 1, 2014 Leukemia is a clonal proliferation of hematopoietic stem cells in the bone marrow. The four broad subtypes most likely to be encountered by primary care physicians are acute lymphoblastic, acute myelogenous, chronic lymphocytic, and chronic myelogenous. Ac ... Link to item Cite

Satiety responsiveness and the relationship between breastfeeding and weight status of toddlers of overweight and obese women.

Journal Article Matern Child Health J · May 2014 Numerous studies indicate an association between breastfeeding and decreased toddler adiposity. The mechanism behind this association is still unknown. One possibility is that children who are breastfed may have increased responsiveness to internal satiety ... Full text Link to item Cite

Patient-centered medical homes and oral anticoagulation therapy initiation.

Journal Article Med Care Res Rev · April 2014 Despite evidence-based guidelines, oral anticoagulation therapy (OAT) initiation is low among incident atrial fibrillation (AF) patients. Patient-centered medical homes (PCMHs) may increase access, quality, and value through coordinating care. As such, PCM ... Full text Link to item Cite

The association between body mass index and coronary artery disease severity: a comparison of black and white patients.

Journal Article Am Heart J · April 2014 INTRODUCTION: Despite known associations between obesity and cardiovascular disease, the relationship between obesity as reflected by body mass index (BMI) and angiographic coronary artery disease (CAD) is not fully understood. Moreover, this relationship ... Full text Link to item Cite

Hint of lyme, an uncommon cause of syncope

Journal Article BMJ Case Reports · March 6, 2014 A 20-year-old Caucasian male patient presented after a single episode of syncope. His heart rate was 40 beats per minute. ECG showed new onset complete heart block. A temporary pacer was placed. He had a macular rash on the body from past 2 weeks and was d ... Full text Cite

Should patients with obesity and hypertension be treated differently from those who are not obese?

Journal Article Curr Hypertens Rep · March 2014 Obesity and hypertension frequently coexist. Measuring blood pressure (BP) accurately in obese patients is challenging and may require strategies that are less accurate, such as forearm cuffing or use of wrist cuffs. Pathophysiologic mechanisms of hyperten ... Full text Link to item Cite

A non-experimental study of oral anticoagulation therapy initiation before and after national patient safety goals.

Journal Article BMJ Open · February 12, 2014 OBJECTIVES: The Joint Commission revised its National Patient Safety Goals (NPSGs) to include oral anticoagulation therapy (OAT) in 2008. We sought to examine the effect of including OAT in The Joint Commission's NPSGs on historically low rates of OAT init ... Full text Link to item Cite

Celiac disease: diagnosis and management.

Journal Article Am Fam Physician · January 15, 2014 Celiac disease is an autoimmune disorder of the gastrointestinal tract. It is triggered by exposure to dietary gluten in genetically susceptible individuals. Gluten is a storage protein in wheat, rye, and barley, which are staples in many American diets. C ... Link to item Cite

Functional capacity in men and women following cardiac rehabilitation.

Journal Article J Cardiopulm Rehabil Prev · 2014 PURPOSE: Cardiac rehabilitation (CR) has been shown to generally increase functional capacity and lower cardiovascular morbidity in patients with ischemic heart disease. The effectiveness of CR in female participants, however, is unclear. We thus examined ... Full text Link to item Cite

Implementation of a pharmacogenomics service in a community pharmacy.

Journal Article J Am Pharm Assoc (2003) · 2014 OBJECTIVE To determine the feasibility of implementing a pharmacogenomics service in a community pharmacy. SETTING A single community pharmacy that is part of a regional chain known for offering innovative pharmacy services. PRACTICE DESCRIPTION Community ... Full text Link to item Cite

A cross-sectional study of medical students' knowledge of patient safety and quality improvement.

Journal Article N C Med J · 2014 BACKGROUND: The Association of American Medical Colleges and the World Health Organization have endorsed formal patient safety and quality improvement (QI) education for medical students. We surveyed medical students to assess their current level of patien ... Full text Link to item Cite

Common questions about vasectomy.

Journal Article Am Fam Physician · December 1, 2013 Vasectomy offers a safe, effective, and permanent method of male contraception, with an overall failure rate of less than 1% in pooled studies. Men older than 30 years in a stable, committed relationship appear to be the best candidates for vasectomy. The ... Link to item Cite

Painful ear nodules.

Journal Article J Fam Pract · September 2013 Was there a connection between our patient's drug use and the appearance of his ears, which were turning black? ... Link to item Cite

Associations of aortic distensibility and arterial elasticity with long-term visit-to-visit blood pressure variability: the Multi-Ethnic Study of Atherosclerosis (MESA).

Journal Article Am J Hypertens · July 2013 BACKGROUND: Although higher visit-to-visit variability (VVV) of blood pressure (BP) is associated with increased cardiovascular disease risk, the physiological basis for VVV of BP is incompletely understood. METHODS: We examined the associations of aortic ... Full text Link to item Cite

Simplifying healthful choices: a qualitative study of a physical activity based nutrition label format.

Journal Article Nutr J · June 6, 2013 BACKGROUND: This study used focus groups to pilot and evaluate a new nutrition label format and refine the label design. Physical activity equivalent labels present calorie information in terms of the amount of physical activity that would be required to e ... Full text Link to item Cite

Hypertension.

Journal Article Prim Care · March 2013 Hypertension is the most common modifiable risk factor for cardiovascular disease. Antihypertensive treatment substantially reduces the risk of heart failure, stroke, and myocardial infarction. Current guidelines recommend screening all adults for high blo ... Full text Link to item Cite

Potential effect of physical activity based menu labels on the calorie content of selected fast food meals.

Journal Article Appetite · March 2013 In this study we examined the effect of physical activity based labels on the calorie content of meals selected from a sample fast food menu. Using a web-based survey, participants were randomly assigned to one of four menus which differed only in their la ... Full text Link to item Cite

Patient safety and quality improvement education: a cross-sectional study of medical students' preferences and attitudes.

Journal Article BMC Med Educ · February 5, 2013 BACKGROUND: Recent educational initiatives by both the World Health Organization and the American Association of Medical Colleges have endorsed integrating teaching of patient safety and quality improvement (QI) to medical students. Curriculum development ... Full text Link to item Cite

Behavioral counseling after screening for alcohol misuse in primary care: a systematic review and meta-analysis for the U.S. Preventive Services Task Force.

Journal Article Ann Intern Med · November 6, 2012 BACKGROUND: Alcohol misuse, which includes the full spectrum from risky drinking to alcohol dependence, is a leading cause of preventable death in the United States. PURPOSE: To evaluate the benefits and harms of behavioral counseling interventions for ado ... Full text Link to item Cite

Medication documentation in a primary care network serving North Carolina medicaid patients: results of a cross-sectional chart review.

Journal Article BMC Fam Pract · August 13, 2012 BACKGROUND: Medical records that do not accurately reflect the patient's current medication list are an open invitation to errors and may compromise patient safety. METHODS: This cross-sectional study compares primary care provider (PCP) medication lists a ... Full text Link to item Cite

Mentorship and job satisfaction among Navy family physicians.

Journal Article Mil Med · August 2012 OBJECTIVE: Among civilian academic physicians, having a mentor is associated with greater job satisfaction. Whether this is true for military physicians is unknown. We sought to examine whether having a mentor is associated with positive job satisfaction a ... Full text Link to item Cite

Exploratory planning and implementation of a pilot pharmacogenetic program in a community pharmacy.

Journal Article Pharmacogenomics · June 2012 AIM: To describe the exploratory planning and implementation of a pilot pharmacogenetic program in a community pharmacy. An institutional review board-approved protocol for a clopidogrel pharmacogenetic program in a community pharmacy was developed to addr ... Full text Link to item Cite

Nighttime blood pressure dipping in young adults and coronary artery calcium 10-15 years later: the coronary artery risk development in young adults study.

Journal Article Hypertension · June 2012 Nighttime blood pressure (BP) dipping can be quantified as the ratio of mean nighttime (sleep) BP to mean daytime (awake) BP. People whose dipping ratio is ≥ 0.90 have been referred to as nondippers, and nondipping is associated with cardiovascular disease ... Full text Link to item Cite

Effect of hawthorn standardized extract on flow mediated dilation in prehypertensive and mildly hypertensive adults: a randomized, controlled cross-over trial.

Journal Article BMC Complement Altern Med · March 29, 2012 BACKGROUND: Hawthorn extract has been used for cardiovascular diseases for centuries. Recent trials have demonstrated its efficacy for the treatment of heart failure, and the results of several small trials suggest it may lower blood pressure. However, the ... Full text Link to item Cite

Does an offer for a free on-line continuing medical education (CME) activity increase physician survey response rate? A randomized trial.

Journal Article BMC Res Notes · March 7, 2012 BACKGROUND: Achieving a high response rate in a physician survey is challenging. Monetary incentives increase response rates but obviously add cost to a survey project. We wondered whether an offer of a free continuing medical education (CME) activity woul ... Full text Link to item Cite

Use of global coronary heart disease risk assessment in practice: a cross-sectional survey of a sample of U.S. physicians.

Journal Article BMC Health Serv Res · January 24, 2012 BACKGROUND: Global coronary heart disease (CHD) risk assessment is recommended to guide primary preventive pharmacotherapy. However, little is known about physicians' understanding and use of global CHD risk assessment. Our objective was to examine US phys ... Full text Link to item Cite

Making pharmacogenetic testing a reality in a community pharmacy.

Journal Article J Am Pharm Assoc (2003) · 2012 OBJECTIVE: To provide information for community pharmacies considering implementation of a pharmacogenetic testing service. SETTING: A single community pharmacy from a regional chain. PRACTICE DESCRIPTION: Community pharmacists at the study site routinely ... Full text Link to item Cite

Resistant hypertension.

Journal Article J Am Board Fam Med · 2012 Resistant hypertension (RH) is defined as blood pressure above a goal despite adherence to at least 3 optimally dosed antihypertensive medications of different classes, one of which is a diuretic. Evaluation of possible RH begins with an assessment of adhe ... Full text Link to item Cite

Microparticles in cardiovascular disease pathophysiology and outcomes.

Journal Article J Am Soc Hypertens · 2012 Microparticles (MPs) are vesicles less than one micron in diameter shed from the plasma membranes of cells that are injured, activated, or undergoing apoptosis. MPs are shed from several types of cells, and the cells of origin can be identified using combi ... Full text Link to item Cite

Calorie menu labeling on quick-service restaurant menus: an updated systematic review of the literature.

Journal Article Int J Behav Nutr Phys Act · December 8, 2011 Nutrition labels are one strategy being used to combat the increasing prevalence of overweight and obesity in the United States. The Patient Protection and Affordable Care Act of 2010 mandates that calorie labels be added to menu boards of chain restaurant ... Full text Open Access Link to item Cite

Long-term prognosis associated with J-point elevation in a large middle-aged biracial cohort: the ARIC study.

Journal Article Eur Heart J · December 2011 AIMS: An association has been described between death from arrhythmia and early repolarization, an electrocardiogram pattern characterized by elevation of the QRS-ST junction (J-point). Little is known about this relationship in non-white populations. This ... Full text Link to item Cite

The polypill to prevent cardiovascular disease: physicians' perspectives.

Journal Article Curr Opin Cardiol · September 2011 PURPOSE OF REVIEW: The term 'polypill' denotes a single-pill combination of drugs for reducing cardiovascular disease events. The 'polypill strategy' refers to making such a pill available to the population based on age (e.g. 55 years) rather than individu ... Full text Link to item Cite

Management of cardiovascular risk in the usual care of Medicaid recipients.

Journal Article J Health Care Poor Underserved · August 2011 Uncontrolled risk factors contribute substantially to cardiovascular disease burden. With retrospective chart review, we examined rates of cardiovascular risk factor assessment and intervention during the course of usual care for a representative sample of ... Full text Link to item Cite

Quality of reporting on randomised controlled trials of auriculotherapy for pain.

Journal Article Acupunct Med · June 2011 OBJECTIVE: The authors investigated the quality of reporting for randomised controlled trials of auriculotherapy for pain before and after the implementation of the Consolidated Standards of Reporting Trials (CONSORT) and Standards for Reporting Interventi ... Full text Link to item Cite

Tolerability of the Oscar 2 ambulatory blood pressure monitor among research participants: a cross-sectional repeated measures study.

Journal Article BMC Med Res Methodol · April 27, 2011 BACKGROUND: Ambulatory blood pressure monitoring (ABPM) is increasingly used to measure blood pressure (BP) in research studies. We examined ease of use, comfort, degree of disturbance, reported adverse effects, factors associated with poor tolerability, a ... Full text Link to item Cite

The HPV vaccine: are dosing recommendations being followed?

Journal Article Vaccine · March 21, 2011 The aims of this study were to determine the percentage of females who after initiating the human papillomavirus (HPV) vaccine series, both completed it and completed it on-time, as well as to examine factors associated with series completion and on-time c ... Full text Link to item Cite

Health literacy interventions and outcomes: an updated systematic review.

Journal Article Evid Rep Technol Assess (Full Rep) · March 2011 OBJECTIVES: To update a 2004 systematic review of health care service use and health outcomes related to differences in health literacy level and interventions designed to improve these outcomes for individuals with low health literacy. Disparities in heal ... Link to item Cite

The contribution of hypertension to black-white differences in likelihood of coronary artery disease detected during elective angiography.

Journal Article Am J Hypertens · February 2011 BACKGROUND: Black patients in the United States undergoing angiography for suspected coronary artery disease (CAD) have consistently been found to have less disease than whites. As the effects of hypertension are greater in blacks than whites, and hyperten ... Full text Link to item Cite

Predisease: when does it make sense?

Journal Article Epidemiol Rev · 2011 Screening often leads to finding conditions that are not at the stage or level that would classify them as disease but, at the same time, are not at a stage or level at which people can be declared entirely disease free. These "in-between" states have some ... Full text Link to item Cite

Diurnal blood pressure pattern and development of prehypertension or hypertension in young adults: the CARDIA study.

Journal Article J Am Soc Hypertens · 2011 Nondippers (people whose sleep systolic blood pressure [SBP] fails to decrease >10% from daytime SBP) have increased risk of cardiovascular disease. The prevalence of nondipping in younger adults has not been well studied, nor has its value for predicting ... Full text Link to item Cite

Assessing and promoting physical activity in African American barbershops: results of the FITStop pilot study.

Journal Article Am J Mens Health · January 2011 This study assessed the feasibility of recruiting African American men in barbershops, assessing their physical activity, conducting physical measurements, and gauging their interest in barbershop-based health research. The authors recruited African Americ ... Full text Link to item Cite

Do clinicians tell patients they have prehypertension?

Journal Article J Am Board Fam Med · 2011 BACKGROUND: the clinical utility of the prehypertension label is questionable. We sought to estimate how often patients with prehypertension are being told about it by their primary care clinicians. METHODS: we conducted a cross-sectional study of adult pa ... Full text Link to item Cite

Acceptance of a Polypill approach to prevent cardiovascular disease among a sample of U.S. physicians.

Journal Article Prev Med · January 2011 OBJECTIVE: To examine US physicians' self-reported knowledge about the Polypill, factors considered in deciding whether to prescribe it, and acceptance of prescribing it for cardiovascular disease (CVD) prevention. METHODS: Numerical scales of 0 (lowest) t ... Full text Link to item Cite

Interventions for individuals with low health literacy: a systematic review.

Journal Article J Health Commun · 2011 The U.S. Department of Health and Human Services recently called for action on health literacy. An important first step is defining the current state of the literature about interventions designed to mitigate the effects of low health literacy. We performe ... Full text Link to item Cite

Diagnosis of secondary hypertension: an age-based approach.

Journal Article Am Fam Physician · December 15, 2010 Secondary hypertension is a type of hypertension with an underlying, potentially correctable cause. A secondary etiology may be suggested by symptoms (e.g., flushing and sweating suggestive of pheochromocytoma), examina- tion findings (e.g., a renal bruit ... Link to item Cite

Reproducibility of masked hypertension in adults with untreated borderline office blood pressure: comparison of ambulatory and home monitoring.

Journal Article Am J Hypertens · November 2010 BACKGROUND: We examined short-term reproducibility of masked hypertension (MH) among adults with recent "borderline" office blood pressure (BP) and compared agreement of ambulatory BP monitoring (ABPM) and home BP monitoring (HBPM) in detecting MH. METHODS ... Full text Link to item Cite

A hypertension risk score for middle-aged and older adults.

Journal Article J Clin Hypertens (Greenwich) · October 2010 Determining which demographic and medical variables predict the development of hypertension could help clinicians stratify risk in both prehypertensive and nonhypertensive persons. Subject-level data from 2 community-based biracial cohorts were combined to ... Full text Link to item Cite

RE: Lowering sodium intake can help reduce hypertension

Journal Article American Family Physician · August 15, 2010 Cite

Global risk of coronary heart disease: assessment and application.

Journal Article Am Fam Physician · August 1, 2010 Coronary heart disease is the most common cause of death in the United States. The conventional risk factor approach to primary prevention excludes many patients who could benefit from preventive therapies. A global risk approach allows more accurate estim ... Link to item Cite

Cost-effectiveness of electrocardiography vs. electrocardiography plus limited echocardiography to diagnose LVH in young, newly identified, hypertensives.

Journal Article Am J Hypertens · June 2010 BACKGROUND: In the United States, screening for left ventricular hypertrophy (LVH) in a newly diagnosed hypertensive patient is typically performed using electrocardiography (ECG). Echocardiography (echo) is a more accurate but also more expensive procedur ... Full text Link to item Cite

Endothelial dysfunction and the risk of hypertension: the multi-ethnic study of atherosclerosis.

Journal Article Hypertension · May 2010 Hypertension is associated with impaired endothelial function in cross-sectional studies. However, few longitudinal data exist on whether endothelial dysfunction precedes the development of hypertension. We examined the cross-sectional and longitudinal rel ... Full text Link to item Cite

Interventions to improve transitional care between nursing homes and hospitals: a systematic review.

Journal Article J Am Geriatr Soc · April 2010 Transitions between healthcare settings are associated with errors in communication of information and treatment plans for frail older patients, but strategies to improve transitional care are lacking. A systematic review was conducted to identify and eval ... Full text Link to item Cite

The effect of giving global coronary risk information to adults: a systematic review.

Journal Article Arch Intern Med · February 8, 2010 BACKGROUND: Global coronary heart disease (CHD) risk estimation (ie, a quantitative estimate of a patient's chances of CHD calculated by combining risk factors in an empirical equation) is recommended as a starting point for primary prevention efforts in a ... Full text Link to item Cite

Level of blood pressure above goal and clinical inertia in a Medicaid population.

Journal Article J Am Soc Hypertens · 2010 Failure to adjust hypertension therapy despite elevated blood pressure (BP) levels is an important contributor to lack of BP control. One possible explanation is that small elevations above goal BP are not concerning to clinicians. BP levels farther above ... Full text Link to item Cite

Influence of a tobacco-free hospital campus policy on smoking status of hospital employees.

Journal Article Am J Health Promot · 2010 PURPOSE: To examine the influence of a tobacco-free hospital campus (TFHC) policy on employee smoking behavior. DESIGN: Questionnaires immediately prior to, 6 months after, and 1 year after implementation of a TFHC policy. SETTING: University-affiliated ho ... Full text Link to item Cite

Effects of labeling patients as prehypertensive.

Journal Article J Am Board Fam Med · 2010 BACKGROUND: Labeling patients as hypertensive has some negative effects. The effects of being labeled as having prehypertension are unknown. We examined whether the label of prehypertension exerts a negative effect on patients' perceived health and whether ... Full text Link to item Cite

Evaluation and management of the patient with difficult-to-control or resistant hypertension.

Journal Article Am Fam Physician · May 15, 2009 High blood pressure is often difficult to control. Resistant hypertension is blood pressure above goal despite adherence to a combination of at least three antihypertensive medications of different classes, optimally dosed and usually including a diuretic. ... Link to item Cite

Hypertensive patients' use of blood pressure monitors stationed in pharmacies and other locations: a cross-sectional mail survey.

Journal Article BMC Health Serv Res · October 22, 2008 BACKGROUND: Blood pressure (BP) monitors are commonly stationed in public places such as pharmacies, but it is uncertain how many people with hypertension currently use them. We sought to estimate the proportion of hypertensive patients who use these types ... Full text Link to item Cite

Volunteerism among surgeons: an exploration of attitudes and barriers.

Journal Article Am J Surg · August 2008 BACKGROUND: In a recent survey, the American College of Surgeons found great interest in surgically related volunteerism, but it was unclear if the interest reflected participation. The purpose of the current study was to explore attitudes and barriers to ... Full text Link to item Cite

Odds ratios and risk ratios: what's the difference and why does it matter?

Journal Article South Med J · July 2008 Odds ratios (OR) are commonly reported in the medical literature as the measure of association between exposure and outcome. However, it is relative risk that people more intuitively understand as a measure of association. Relative risk can be directly det ... Full text Link to item Cite

How and why do patients use home blood pressure monitors?

Journal Article Blood Press Monit · June 2008 INTRODUCTION: Little is known about how and why patients use home blood pressure monitoring (HBPM). We investigated from where patients obtain their monitor, their reasons for using HBPM, and their frequency of performing blood pressure (BP) measurements. ... Full text Link to item Cite

Use of home blood pressure monitoring by hypertensive patients in primary care: survey of a practice-based research network cohort.

Journal Article J Clin Hypertens (Greenwich) · April 2008 Using a survey of a cohort of primary care patients, the authors determined the proportion currently using home blood pressure monitoring (HBPM) and calculated odds ratios (ORs) of factors associated with such use. Overall, 530 questionnaires were received ... Full text Link to item Cite

Preliminary study of a school-based program to improve hypertension awareness in the community.

Journal Article Fam Med · April 2008 BACKGROUND AND OBJECTIVES: We developed a school-based program to raise community awareness about hypertension. We studied the results of the program on the outcomes of parental knowledge about high blood pressure (BP) and their reports of having seen or i ... Link to item Cite

The MD-MPH program at the University of North Carolina at Chapel Hill.

Journal Article Acad Med · April 2008 In 1997, the Schools of Medicine and Public Health at the University of North Carolina at Chapel Hill (UNC) developed a formal MD-MPH program, called the Health Care and Prevention (HC&P) Program, located in the Public Health Leadership Program in the UNC ... Full text Link to item Cite

Lifestyle modifications to lower or control high blood pressure: is advice associated with action? The behavioral risk factor surveillance survey.

Journal Article J Clin Hypertens (Greenwich) · February 2008 Routine lifestyle modification advice for managing high blood pressure (BP) is of questionable effectiveness. Using data from the 2005 Behavior Risk Factor Surveillance System, we examined whether receipt of advice is associated with reported adoption of l ... Full text Link to item Cite

Research published in 2003 by U.S. family medicine authors.

Journal Article J Am Board Fam Med · 2008 OBJECTIVES: The discipline of family medicine seeks to build its research enterprise. To assess the state of family medicine research in the United States, this study identifies and describes research articles published by family medicine researchers from ... Full text Link to item Cite

High blood pressure knowledge among primary care patients with known hypertension: a North Carolina Family Medicine Research Network (NC-FM-RN) study.

Journal Article J Am Board Fam Med · 2008 BACKGROUND: We sought to assess primary care patients' current knowledge about various aspects of high blood pressure (BP). METHODS: We mailed a questionnaire to 700 hypertensive patients enrolled in a practice-based research network cohort from 24 practic ... Full text Link to item Cite

Lifestyle modification advice for lowering or controlling high blood pressure: who's getting it?

Journal Article J Clin Hypertens (Greenwich) · November 2007 Lifestyle modifications (LSMs) are important in hypertension management. Using data from a population-based sample of hypertensive adults (N=28,457), the authors examined variations in reports of receipt of LSM advice by patient characteristics. Most adult ... Full text Link to item Cite

Validation of the HEM-780REL with easy wrap cuff for self-measurement of blood pressure according to the European Society of Hypertension International Protocol.

Journal Article Blood Press Monit · October 2007 OBJECTIVE: We tested the accuracy of the HEM-780REL automatic blood pressure monitor with Easy Wrap Cuff. METHODS: We used the International Protocol for validation of blood pressure measuring devices developed by the Working Group on Blood Pressure Monito ... Full text Link to item Cite

Will diagnosing prehypertension help? [5]

Journal Article Journal of the American Board of Family Medicine · May 1, 2007 Full text Cite

Eliminating bias in randomized controlled trials: importance of allocation concealment and masking.

Journal Article Fam Med · February 2007 Randomization in randomized controlled trials involves more than generation of a random sequence by which to assign subjects. For randomization to be successfully implemented, the randomization sequence must be adequately protected (concealed) so that inve ... Link to item Cite

The new "normal" blood pressure: what are the implications for family medicine?

Journal Article J Am Board Fam Med · 2007 BACKGROUND: In 2003, the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure redefined normal blood pressure (BP) as less than 120/80 mm Hg and added the category of prehypertension, recommending that such pa ... Full text Link to item Cite

Effects of sex, age, and visits on receipt of preventive healthcare services: a secondary analysis of national data.

Journal Article BMC Health Serv Res · February 23, 2006 BACKGROUND: Sex and age may exert a combined influence on receipt of preventive services with differences due to number of ambulatory care visits. METHODS: We used nationally representative data to determine weighted percentages and adjusted odds ratios of ... Full text Link to item Cite

Adults' lack of a usual source of care: a matter of preference?

Journal Article Ann Fam Med · 2006 PURPOSE: We wanted to identify characteristics of adults who do not have a usual source of care and then stratify the analysis by those who prefer vs those who do not prefer to have a usual source of care. METHODS: We analyzed data from a nationally repres ... Full text Link to item Cite

Understanding interobserver agreement: the kappa statistic.

Journal Article Fam Med · May 2005 Items such as physical exam findings, radiographic interpretations, or other diagnostic tests often rely on some degree of subjective interpretation by observers. Studies that measure the agreement between two or more observers should include a statistic t ... Link to item Cite

Off-label uses for selective serotonin reuptake inhibitors.

Journal Article Am Fam Physician · January 1, 2005 Link to item Cite

Pruritic urticarial papules and plaques of pregnancy presenting in the postpartum period: a case report.

Journal Article J Reprod Med · January 2005 BACKGROUND: Pruritic urticarial papules and plaques of pregnancy (PUPPP), also known as polymorphic eruption of pregnancy, is the most common dermatosis of pregnancy. It usually evolves in the third trimester and resolves rapidly postpartum. CASE: A 25-yea ... Link to item Cite

Pelvic inflammatory disease

Journal Article Clinics in Family Practice · January 1, 2005 Full text Cite

Atypical pathogens and challenges in community-acquired pneumonia

Journal Article South African Family Practice · January 1, 2005 Atypical organisms such as Mycoplasma pneumoniae, Chlamydia pneumoniae, and Legionella pneumophila are implicated in up to 40 percent of cases of community-acquired pneumonia. Antibiotic treatment is empiric and includes coverage for both typical and atypi ... Cite

Night sweats are commonly vasomotor symptoms.

Journal Article Am Fam Physician · October 1, 2004 Link to item Cite

Milk-like serum suggests markedly elevated triglycerides.

Journal Article Am Fam Physician · September 1, 2004 Link to item Cite

Polycythemia vera.

Journal Article Am Fam Physician · May 1, 2004 Polycythemia vera is a chronic myeloproliferative disorder characterized by increased red blood cell mass. The resultant hyperviscosity of the blood predisposes such patients to thrombosis. Polycythemia vera should be suspected in patients with elevated he ... Link to item Cite

Atypical pathogens and challenges in community-acquired pneumonia.

Journal Article Am Fam Physician · April 1, 2004 Atypical organisms such as Mycoplasma pneumoniae, Chlamydia pneumoniae, and Legionella pneumophila are implicated in up to 40 percent of cases of community-acquired pneumonia. Antibiotic treatment is empiric and includes coverage for both typical and atypi ... Link to item Cite

Management of swimming-induced pulmonary edema.

Journal Article Am Fam Physician · March 1, 2004 Link to item Cite

Velvety axillary lesions.

Journal Article Am Fam Physician · January 15, 2004 Link to item Cite

A retrospective review of performance and utility of routine clinical pelvimetry.

Conference Fam Med · 2004 BACKGROUND AND OBJECTIVES: Some authorities have questioned the utility of performing clinical pelvimetry as part of routine prenatal care. This study determined the frequency with which clinical pelvimetry is still performed at two military hospitals and ... Link to item Cite

Heparin prevents recurrent VTE in cancer patients

Journal Article Journal of Family Practice · November 1, 2003 Cite

Diagnosing night sweats requires clear definition.

Journal Article Am Fam Physician · October 1, 2003 Link to item Cite

Off-label applications for SSRIs.

Journal Article Am Fam Physician · August 1, 2003 Selective serotonin reuptake inhibitors (SSRIs) are widely used because of their safety, tolerability, and demonstrated efficacy across a broad range of clinical conditions. Medical literature supports the use of SSRIs for the treatment of many conditions ... Link to item Cite

Management of carpal tunnel syndrome.

Journal Article Am Fam Physician · July 15, 2003 Carpal tunnel syndrome affects approximately 3 percent of adults in the United States. Pain and paresthesias in the distribution of the median nerve are the classic symptoms. While Tinel's sign and a positive Phalen's maneuver are classic clinical signs of ... Link to item Cite

Thyroid function testing in outpatients: are both sensitive thyrotropin (sTSH) and free thyroxine (FT4) necessary?

Conference Fam Med · June 2003 BACKGROUND AND OBJECTIVES: Despite improved thyroid function testing assays, appropriate use of these commonly ordered tests to detect thyroid dysfunction remains controversial. This study determined if a normal sensitive thyroid stimulating hormone (sTSH) ... Link to item Cite

Diagnosing night sweats.

Journal Article Am Fam Physician · March 1, 2003 Night sweats are a common outpatient complaint, yet literature on the subject is scarce. Tuberculosis and lymphoma are diseases in which night sweats are a dominant symptom, but these are infrequently found to be the cause of night sweats in modern practic ... Link to item Cite

Management of irritable bowel syndrome.

Journal Article Am Fam Physician · November 15, 2002 Irritable bowel syndrome is the most common functional disorder of the gastrointestinal tract and is frequently treated by family physicians. Despite patients' worries about the symptoms of irritable bowel syndrome, it is a benign condition. The diagnosis ... Link to item Cite

Hyperparathyroidism

Journal Article Clinics in Family Practice · January 1, 2002 Primary hyperparathyroidism is currently most often diagnosed after noting elevated serum calcium on routine testing. Most of these patients have a single parathyroid gland adenoma. Surgery can normalize biochemical parameters in 95% of patients, but a pat ... Full text Cite

Remedies for prolonged hiccups.

Journal Article Am Fam Physician · May 1, 2001 Link to item Cite

Radon and lung cancer.

Journal Article Am Fam Physician · September 1, 2000 Link to item Cite

Practical use of the pessary.

Journal Article Am Fam Physician · May 1, 2000 The pessary is an effective tool in the management of a number of gynecologic problems. The pessary is most commonly used in the management of pelvic support defects such as cystocele and rectocele. Pessaries can also be used in the treatment of stress uri ... Link to item Cite

Rectal prolapse during pregnancy. A case report.

Journal Article J Reprod Med · January 2000 BACKGROUND: Rectal prolapse is a bothersome surgical problem that is relatively infrequent. It usually occurs in the fifth to seventh decades of life and is more common in women. CASE: A 33-year-old woman, gravida 3, para 2, was found to have a large recta ... Link to item Cite

Physostigmine in the Treatment of y-Hydroxybutyric Acid Overdose

Journal Article Mayo Clinic Proceedings · January 1, 2000 The widespread abuse of the recreational drug γ-hydroxybutyric acid has resulted in several reports of overdose leading to coma. The use of a short-acting anticholinesterase agent such as physostigmine as a potential reversal agent has been proposed previo ... Full text Cite

Breast-feeding with ectopic axillary breast tissue.

Journal Article Mayo Clin Proc · October 1999 Axillary breast tissue, which may be an extension of the tail of Spence, is a normal variant that has been reported in the literature relatively infrequently, although it may be present in a number of asymptomatic women. If axillary breast tissue becomes s ... Full text Link to item Cite

Newer pharmacologic alternatives for erectile dysfunction.

Journal Article Am Fam Physician · September 15, 1999 With the introduction of effective pharmacologic therapies for erectile dysfunction, more men are seeking treatment. The underlying cause of erectile dysfunction is usually a chronic medical illness or a side effect of certain drugs. Less commonly, the pro ... Link to item Cite

Sister (Mary?) Joseph's node.

Journal Article Am Fam Physician · June 1999 Link to item Cite

Photo quiz. A subtle ECG.

Journal Article Am Fam Physician · May 1, 1999 Link to item Cite

Toxic ingestion of gamma-hydroxybutyric acid.

Journal Article South Med J · April 1999 Gamma-hydroxybutyric acid (GHB) has become a popular new drug of abuse. Its effects include euphoria and disinhibition. Recently, several cases have been reported in the literature of life-threatening or lethal ingestions. We report the case of a 17-year-o ... Full text Link to item Cite

Photo quiz. Vaginal bleeding at 16 weeks.

Journal Article Am Fam Physician · February 1, 1999 Link to item Cite

Primary upper-extremity deep venous thrombosis.

Journal Article Mil Med · December 1997 Using an illustrative case, this report reviews the entity of primary upper-extremity deep venous thrombosis, also known as Paget-Schroetter syndrome. The entity of Paget-Schroetter syndrome is important to military physicians because of its occurrence in ... Link to item Cite