The Medical Roundtable Cardiovascular Edition Vol 1 Iss 2

“I think what’s difficult is to take observational data and to say, well, because there’s a relationship … then lower the levels of all these things … but I really think that to decide whether to treat those particular risk factors, and how low to go with those, we … need clinical trial data.”
-William Cushman, MD

The Medical Roundtable General Medicine Edition Vol 1 Iss 1

“Alzheimer’s disease is really much more than a memory impairment, … an older adult who is having changes in their mood, their interests, their patience, their behavior, their personality; these may all herald the beginning of Alzheimer’s disease.”
~ James E. Galvin, MD

The Medical Roundtable Cardiovascular Edition Vol 1 Iss 2

“I would say we probably need to define another category for severe MR, which is regurgitant volume above 100 mL, which would be a massive degree of MR.”
-Maurice Sarano, MD

The Medical Roundtable General Medicine Edition Vol 1 Iss 2

“When you say the word fitness to people it often confuses them; they’ll think about flexibility, they’ll think about muscular strength, and they’ll of course think about how easily they get out of shape. Today we’re specifically talking about cardiorespiratory fitness, which is really your maximal aerobic capacity.”
~ Timothy Church

The Medical Roundtable Cardiovascular Edition Vol 1 Iss 1

Some people also have been advocating echocardiograms, but I don’t think I’ll be out of line with this audience to say that including echocardiograms is a bit on the fringe of what we’re talking about, and really the argument centers more on using the ECG as a primary screening tool.
-Ben Levine, MD

The Medical Roundtable General Medicine Edition Vol 1 Iss 2

"Currently there are thousands of practices and millions of patients being served by medical homes across the country, and it is incumbent upon us to understand where this model has come from, and where it is going."
~Asaf Bitton

The Medical Roundtable Cardiovascular Edition Vol 3 Iss 4

"I think one of the challenges we deal with is how to handle patients who don’t have a high enough blood pressure to get all the evidence-based therapies we want them on. In many patients with MI, at least in the early phase, blood pressure is tenuous."

James de Lemos, MD

The Medical Roundtable Cardiovascular Edition Vol 2 Iss 2

“So I think one key modification of ATP IV will be to focus on non-HDL cholesterol as a treatment target equal to that of LDL cholesterol.”
~ Michael Davidson, MD

The Medical Roundtable Cardiovascular Edition Vol 1 Iss 2

“It is very common for these patients to report New York Heart Association functional class 1 after myectomy—that is, they can do virtually anything…”
-Barry Maron, MD

The Medical Roundtable Cardiovascular Edition Vol 2 Iss 3

“As we entered this era of drug-eluting stents, we obtained some evidence that we are decreasing the need for repeat procedures, but the question remains, is it really as safe as surgery?”
~ Spencer King, MD

The Medical Roundtable Cardiovascular Edition Vol 3 Iss 4

"Hypertension continues to be a major contributor of cardiovascular events, and there is sufficient evidence to indicate that adequate blood pressure (BP) control is associated with marked reductions in the risk of not only target organ damage but also cardiovascular events such as stroke, myocardial infarction, and chronic renal failure."

Carlos M. Ferrario, MD

The Medical Roundtable Cardiovascular Edition Vol 2 Iss 3

“Unfortunately I think the level of understanding of the complexity of degenerative mitral valve disease, while increasing, is not at a high level among many imaging cardiologists.”
~ Randy Martin, MD

The Medical Roundtable Cardiovascular Edition Vol 3 Iss 1

"These are guidelines created to guide people in decision making, but there is latitude based on patients’ underlying medical conditions, underlying psychiatric conditions, and other issues that may come into play, and all of these things need to be considered."
~ John D. Fisher, MD

The Medical Roundtable Cardiovascular Edition Vol 2 Iss 4

“…patients who are device candidates are far and away most interested in receiving a device that will make them feel better rather than live longer…”
~ Jonathan Steinberg, MD

The Medical Roundtable Cardiovascular Edition Vol 1 Iss 3

“… digoxin is even more pertinent in the context of the increasing prevalence of heart failure with preserved ejection fraction.”
~ Michael White, MD

The Medical Roundtable Cardiovascular Edition Vol 1 Iss 4

“…this is an exciting new frontier for hypertension research and management. Masked hypertension is not just not a curiosity.”
~ Robert Phillips, MD

The Medical Roundtable General Medicine Edition Vol 1 Iss 1

“Certain activities like racquet sports, skiing, and basketball seem to be associated with a greater incidence of acute cardiovascular events. Many of these victims, especially those younger than 35, often have underlying structural cardiovascular abnormalities, most notably hypertrophic cardiomyopathy.”
~ Barry Franklin

The Medical Roundtable General Medicine Edition Vol 1 Iss 1

“There are lots of reasons to be skeptical about the results of randomized trials ... There’s at least a collection of circumstances in which when they come head-to-head, it seems that you agree that the results of randomized trials would trump prior physiologic reasoning and clinical experience.”
~ Gordon Guyatt

The Medical Roundtable Cardiovascular Edition Vol 3 Iss 3

"African Americans, and in particular African American women … carry the highest risk in the United States for having [CAD, MI, and CV morbidity and mortality]. Unfortunately African Americans, Hispanics and women of all ethnicities suffer from a disparity in access to life saving technologies and pharmacologic therapies."
Christopher Leggett, MD

The Medical Roundtable Cardiovascular Edition Vol 1 Iss 1

So in other words, for coronary artery disease, a clear J-shaped curve; for stroke there was no J-shaped curve.
-Franz Messerli, MD

The Medical Roundtable Cardiovascular Edition Vol 2 Iss 1

“I try to avoid the term ‘vulnerable plaque’ because it implies that we possess a crystal ball that can tell the future of a particular lesion based solely on its morphology.”
~ Peter Libby, MD

The Medical Roundtable Cardiovascular Edition Vol 3 Iss 2

"With the improved respiratory flow monitoring that we have nowadays using a pressure transducer technique, the accuracy of detecting obstructive events— particularly when we speak about apneas— really has improved."
~ Ana Krieger, MD, MPH

The Medical Roundtable Cardiovascular Edition Vol 3 Iss 3

"This is a growing population and these patients are at risk of going on and developing more symptomatic advanced HF in the future, ... I think there is a substantial need for developing new therapies and new approaches using novel strategies for the management of these patients."
Barry Greenberg, MD

The Medical Roundtable Cardiovascular Edition Vol 1 Iss 2

“I think it’s been an evolving process and I think it’s a good one. Moreover, transparently acknowledging a medical writer’s contributions clearly highlights the fact that this is a legitimate area of scientific endeavor.”
-Carol Sanes-Miller

The Medical Roundtable Cardiovascular Edition Vol 2 Iss 4

“These therapies are now mainstream for the bridge-to-transplant population, as well as for patients who are ineligible for transplant … The outcomes in the destination therapy populations have been just as good in the transplant population—it’s certainly a leap forward, as compared to the previous generation of devices.”
~ Andrew Boyle, MD

The Medical Roundtable General Medicine Edition Vol 1 Iss 2

"Narcolepsy is a disorder that’s interesting because it typically does get missed. Although patients may present with complaints of tiredness and fatigue, very often people don’t think of narcolepsy as being a possible cause."
~Michael Thorpy

The Medical Roundtable General Medicine Edition Vol 1 Iss 1

“It could be tremendous for prevention in children. After being followed, maybe they will come back to have fewer drug problems, smoking issues.”
~ James Dalen

The Medical Roundtable Cardiovascular Edition Vol 2 Iss 1

“Reversing obesity prevalence in the United States to that of a decade ago has been estimated to save US adults 111,206 total knee replacements."
~ Gary Williams, MD

The Medical Roundtable General Medicine Edition Vol 1 Iss 1

“In depression care … we are increasingly calling for the use of standardized instruments and repeated measures.”
~ Alan Gelenberg

The Medical Roundtable General Medicine Edition Vol 1 Iss 1

“There’s no question that aspirin decreases non-fatal MI in randomized trials of primary prevention and their meta-analyses, probably by about 20% … Because the number of deaths is not decreased, people assume that there’s no merit in preventing nonfatal MI. I don’t agree with that.”
~ James Dalen

The Medical Roundtable Cardiovascular Edition Vol 3 Iss 1

"The key point that we found is …that interpreting the treadmill test on the basis of the ST segment alone is obsolete and should be abandoned…I think an important point we need to make to clinicians is that the most important prognostic indicator is functional capacity."
~ Ezra A. Amsterdam, MD

The Medical Roundtable General Medicine Edition Vol 1 Iss 2

"The average person is gaining weight every year. So I get discouraged when people see that information and feel like everybody gains it back."
~Sherry Pagoto

The Medical Roundtable Cardiovascular Edition Vol 2 Iss 4

“I think thiazides offer the advantage of an anti-calciuric effect, so that women will tend to retain calcium, which has been demonstrated to facilitate bone mineralization with older age.”
~ Matthew Weir, MD

The Medical Roundtable Cardiovascular Edition Vol 3 Iss 3

"I think one of the things that is important for physicians to understand is that … we’ve had a long history of using a very complicated drug, warfarin. The new drugs are a significant advance, but they’re not necessarily going to be a cakewalk."
Peter Kowey, MD

"One of the more controversial issues in medicine has been that of hypertension in pregnant women. The guidelines have not changed much in the last 50 years, although some effort to update these guidelines has been made recently."

Marvin Moser, MD

The Medical Roundtable General Medicine Edition Vol 1 Iss 1

“The Lyon Mediterranean Diet Study had a 70% reduction in cardiac events—a benefit that exceeded that of most drug trials.”
~ Stephen Devries

The Medical Roundtable Cardiovascular Edition Vol 1 Iss 3

“We have two studies, the randomized trial and the observational study that suggest that ACE inhibitors and ARBs … may not be useful, [and] may actually be harmful in patients with AR…”
~ Jeffrey Borer, MD

The Medical Roundtable Cardiovascular Edition Vol 3 Iss 1

"There are a lot of… small studies that have evaluated whether or not the addition of a thiazide such as metolazone to a loop diuretic augments sodium excretion and urine output."
~ Tien Ng, PharmD

The Medical Roundtable Cardiovascular Edition Vol 1 Iss 3

“Moderate-intensity activity is something that you can do while … talking comfortably, but you cannot sing.”
~ I-Min Lee, MD

The Medical Roundtable Cardiovascular Edition Vol 1 Iss 4

“So JNC 8 might say that home BPs will be helpful in determining what the pressure is over time, but presently there is no trial evidence that knowing home blood pressures will decrease events.”
~ Marvin Moser, MD

The Medical Roundtable General Medicine Edition Vol 1 Iss 4

"Osteoporosis is a very common problem that primary care practitioners encounter every day, not only with patients who come in with osteoporosis but also with those with a variety of other diseases."

Eric Gall

The Medical Roundtable General Medicine Edition Vol 1 Iss 2

"Atherosclerosis is a systemic disease, not a regional disease. If one has plaques in the coronary arteries, they also have plaques in the peripheral arteries including the carotid arteries."
~William C. Roberts

The Medical Roundtable Cardiovascular Edition Vol 1 Iss 1

But for now, I would agree that this intermediate or low-to-intermediate risk group is the best group to target for coronary CT scanning.
-Allen Taylor, MD

The Medical Roundtable Cardiovascular Edition Vol 2 Iss 2

“[Redistribution of abdominal fat is] one of the most rewarding things that we can see, as physicians caring for these patients, because we know that ... means we’re going to see gradual improvements in the HDL and triglycerides over time.”
~ Malissa Wood, MD

The Medical Roundtable Cardiovascular Edition Vol 3 Iss 1

"Cholesteryl ester transfer protein has been an important target for the management of risk for cardiovascular disease. It began a number of years ago when it was noted that this protein transfers cholesteryl ester in exchange for triglyceride from different lipoproteins specifically, apoB-lipoproteins to HDL lipoproteins."
~ Michael Davidson, MD

The Medical Roundtable Cardiovascular Edition Vol 2 Iss 2

“I have to say my view of CRT is that it probably does make the heart better. Therefore the assumption that sicker patients are going die of progressive heart failure rather than from an arrhythmia can be overcome by having a CRT device in the patient who has significant dyssynchrony or wide QRS.”
~ Barry Massie, MD

The Medical Roundtable Cardiovascular Edition Vol 2 Iss 3

“All the registry data indicate that the ICD is extremely effective in not only treating fast VT or VF, but also in preventing sudden cardiac death.”
~ Mark Estes, MD

The Medical Roundtable General Medicine Edition Vol 1 Iss 4

"Scientific advances in acupuncture research, coupled with the side effects of treating pain by conventional drugs, have promoted the use of acupuncture dramatically in the past 20 years. It is estimated that over 1 million practitioners outside China administer acupuncture treatments for chronic pain. Of these practitioners, over 300000 are physicians."

Brian Berman

The Medical Roundtable Cardiovascular Edition Vol 1 Iss 3

“We need to differentiate real life from what goes on in the clinical trials, because so often in the clinical trials patients with a history of myopathy … are excluded from the trials.”
~ Peter Toth, MD

The Medical Roundtable Cardiovascular Edition Vol 2 Iss 2

“I believe there are some recent data that this increase [in obesity] seems to have leveled off, but at a rate that is still very unhealthy, with two thirds of the adult population being overweight and one third being obese.”
~ Jerome Fleg, MD

"We are now seeing many such patients [with heart failure with preserved ejection fraction]. They’re often elderly women with many comorbid conditions, and they’re sometimes admitted with atrial fibrillation, which makes the estimation of diastolic function problematic."

Gary Francis, MD

"Guidelines [for heart failure with preserved ejection fraction] don’t have much to say…Treatment remains relatively empiric, and different clinicians have different biases that affect the treatment that they provide…Several small studies have shown that some agents seem to work…[but] there hasn’t been a lot of evidence of benefit."

Barry Massie, MD

The Medical Roundtable Cardiovascular Edition Vol 3 Iss 2

"Patients and physicians may be attracted to a less invasive angioplasty and stenting approach for suitable coronary lesions, however, there are issues with the recommended anticoagulation regimens, which could include two antiplatelet drugs and another anticoagulant if the patient is in atrial fibrillation."
~ William Frishman, MD

The Medical Roundtable General Medicine Edition Vol 1 Iss 4

"We know that celiac disease is a genetic autoimmune disease, and we know that non-celiac gluten sensitivity is not considered an autoimmune disease… In order to obtain a diagnosis of non-celiac gluten sensitivity, celiac disease and a wheat allergy would both need to be ruled out."

Melinda Dennis

The Medical Roundtable General Medicine Edition Vol 1 Iss 3

"Practitioners will certainly want to keep in mind that to make optimal decisions, you need systematic summaries of the best evidence."

Gordon Guyatt

The Medical Roundtable Cardiovascular Edition Vol 1 Iss 4

“That implies that the percutaneous-inserted prosthesis implanted inside the existing native valve without excising that valve has hemodynamics after implantation that are nearly as good as a stented bioprosthetic valve replacement. That was surprising to me…”
~ Paul Grayburn, MD

The Medical Roundtable Cardiovascular Edition Vol 1 Iss 4

“CPX testing has been a major component of research with heart failure patients and has migrated into the clinical care of heart failure patients.”
~ David Whellan, MD

The Medical Roundtable Cardiovascular Edition Vol 2 Iss 1

“The new finding was that an elevated heart rate above 70 beats per minute was also associated with an increase in hospitalization for fatal and non-fatal myocardial infarction.”
~ Kim Fox, MD

The Medical Roundtable Cardiovascular Edition Vol 3 Iss 4

"It seems like the biggest change in the guidelines is the addition of ticagrelor, or BRILINTA®.… a new antiplatelet therapy that has been shown to be effective in ACS. Actually, based on the PLATO trial and the current [US FDA] rulings, it’s the only antiplatelet agent that is superior to clopidogrel for reducing cardiovascular death following ACS.…"

Carl J. Lavie, MD

The Medical Roundtable Cardiovascular Edition Vol 1 Iss 2

“Even if people developed diabetes, they would still benefit from statin therapy, so the [JUPITER] panel concluded that the cardiovascular benefit outweighed the increase in the risk of diabetes.”
-Antonio Gotto, MD

The Medical Roundtable Cardiovascular Edition Vol 3 Iss 3

"In general, if someone has an indication for revascularization, the stenting or an angioplasty approach is more commonly used in single- or double-vessel disease. More extensive multivessel disease and left main disease historically have been more often treated with bypass surgery."
Jeffrey Snell, MD

The Medical Roundtable Cardiovascular Edition Vol 2 Iss 1

“... only about 10% of the patients in RALES were on a beta blocker, but those who were ... seemed to have just as good, if not a better, result from spironolactone."
~ Bertram Pitt, MD

The Medical Roundtable Cardiovascular Edition Vol 1 Iss 3

“The data is pretty convincing that adding an aldosterone blocker on top of standard therapy is effective and an important strategy.”
~ Bertram Pitt, MD

The Medical Roundtable Cardiovascular Edition Vol 3 Iss 4

"HF [heart failure] is slightly more common in women—just over half of the HF population—and they certainly have more hypertension than we ever expected."

W. Frank Peacock, MD

The Medical Roundtable Cardiovascular Edition Vol 2 Iss 2

“Another critical step in the selection of patients is the assessment of aortic valve anatomy of the vascular accesses, and the presence of comorbidities. The main cause of mortality within the first year after TAVR are the comorbidities.”
~ Gian Paolo Ussia, MD

The Medical Roundtable Cardiovascular Edition Vol 2 Iss 2

“I am greatly concerned that, instead of supplementing what we learn at the bedside, we’re replacing it with modern imaging technology.”
~ John Michael Criley, MD

The Medical Roundtable General Medicine Edition Vol 1 Iss 4

"[There] is a group of migraineurs who have increased frequency and some change in quality. The treatment effects are perhaps important for them…Does analgesic use drive or follow the problem?"

Peter Goadsby

The Medical Roundtable Cardiovascular Edition Vol 2 Iss 3

“Investigations from those centers have shown a two- to three-fold rise in the occurrence of aneurysm disease compared to three to four decades ago. So, this appears to be bona fide, based on pretty comprehensive epidemiologic data from these isolated localities.”
~ John Elefteriades, MD

The Medical Roundtable General Medicine Edition Vol 1 Iss 2

"We know the younger the patient is with thoracic aortic disease, the more likely there is to be an underlying genetic cause for the disease. The older the patient is … the less likely they are to have genetic risk factors and the more likely they are to have chronic wear and tear on the aorta over a lifetime causing the thoracic aortic disease."
~Dianna Milewicz

The Medical Roundtable General Medicine Edition Vol 1 Iss 4

"Investigators and clinicians alike have realized that the pragmatic approach, using the presence or absence of constipation as a symptom of IBS, may lend itself to the subsequent evaluation and management of the disorder."

Brooks Cash

The Medical Roundtable General Medicine Edition Vol 1 Iss 2

"Behavioral interventions have yielded improvements on the order of 35% to 55% reductions in headache from pretreatment to post-treatment indicating that they're viable interventions. Those observed outcomes are approximately equivalent to the best prophylactic medications for primary headache."
Donald B. Penzien

The Medical Roundtable Cardiovascular Edition Vol 3 Iss 3

"The difference in clinical practice is that individuals may not be as stringent at monitoring, and so I think hyperkalemia gets captured potentially a lot sooner in clinical trials as opposed to in clinical practice."
Orly Vardeny, PharmD

The Medical Roundtable Cardiovascular Edition Vol 3 Iss 2

"Mitral valve repair has been the gold standard for patients with mitral regurgitation (MR) for approximately 30 years. What is the likelihood that percutaneous procedures will be able to achieve the same sort of efficacy for MR in the future?"
~ Michael A. Borger, MD

The Medical Roundtable Cardiovascular Edition Vol 2 Iss 4

“If you show up in the ED and you have either an elevated troponin or an elevated adrenomedullin, your risk of death in the next two weeks is exceedingly high and you ought to get aggressive care.”
~ Alan Maisel, MD

The Medical Roundtable General Medicine Edition Vol 1 Iss 2

"I completely agree that we should avoid this kind of storm during the dialysis session. There are so many changes in the different ions that could trigger some arrhythmia. I completely agree that we should avoid important gradients, whether the ion is calcium or potassium."

Pieter Evenepoel

The Medical Roundtable Cardiovascular Edition Vol 2 Iss 4

“Aspirin is said to minimize the flushing that occurs with the niacin products. Many of the patients we would consider candidates for niacin need to be on aspirin anyway because they’re high-risk.”
~ Peter H. Jones, MD

The Medical Roundtable General Medicine Edition Vol 1 Iss 4

"Low back pain is a perfect example of how complexity based on biopsychosocial-spiritual influences can influence the severity of pain as well as suffering."

David Rakel

The Medical Roundtable Cardiovascular Edition Vol 1 Iss 4

“…it’s been bandied about that the classic risk factors account for only 50% of the risk of atherosclerotic vascular disease. … We refer to this as the ‘50% myth’ and we need to refute it.”
~ Ezra Amsterdam MD

The Medical Roundtable General Medicine Edition Vol 1 Iss 3

"Most importantly, not everybody in the population with a migraine needs neuroimaging, but that depends on detailed clinical symptoms."

Tobias Kurth

The Medical Roundtable Cardiovascular Edition Vol 2 Iss 3

“There is no question that these drugs have a major role to play in therapy. In every clinical trial over the past 50 years, where they have been used as monotherapy or in combination with other therapies they not only effectively lowered blood pressure, but morbidity and mortality were reduced not just from stroke, but from heart failure, progression of kidney disease, and coronary disease.”
~ Marvin Moser, MD

The Medical Roundtable Cardiovascular Edition Vol 3 Iss 2

"The difference between a prevalence of disease in patients with normal results or normal testing was in the order of 15% to 20%, which really questions how much better testing is than just flipping a coin and whether it might be just as well to proceed with angiography."
~ Mario Garcia, MD

The Medical Roundtable Cardiovascular Edition Vol 3 Iss 3

"There are mechanistic studies that indicate that the effect of ezetimibe on LDL is really not so much on the production side; turnover studies show that hepatic catabolism of LDL particles is important, and that is remote from the enterocyte and the whole supply side mechanism."
Robert Hegele, MD

The Medical Roundtable Cardiovascular Edition Vol 3 Iss 2

"The standard of therapy is not known, so that’s why if you select a patient who we don’t want to operate on, there is no competition there."
~ Saibal Kar, MD

The Medical Roundtable Cardiovascular Edition Vol 3 Iss 1

"I think everyone knows that there are chronic risk factors such as high blood pressure, dyslipidemia, diabetes, smoking, lack of exercise, and others that contribute to coronary artery disease. We’ve only become aware recently of the issue that there are other kinds of risk factors, including what might be called acute risk factors."
~ Robert A. Kloner, MD, PhD

The Medical Roundtable General Medicine Edition Vol 1 Iss 1

“Patients with MetS and high triglycerides are the most likely to develop diabetes in the relatively near future. All patients with MetS, especially those with high triglycerides, need to be treated aggressively with TLCs and adjunctive drug therapies of proven benefit.”
~ Charles Hennekens

The Medical Roundtable Cardiovascular Edition Vol 2 Iss 3

“There is controversy over whether patients with chronic hypertension who have compensated concentric ventricular hypertrophy ever evolve into more dilated HF.”
~ David Kass, MD

"FH [familial hypercholesterolemia] is associated with an increased risk of premature CVD [cardiovascular disease], and its prevalence is increased in certain founder populations."

~James Underberg, MD

The Medical Roundtable Cardiovascular Edition Vol 3 Iss 1

"Many clinicians for years have prescribed niacin for people with low HDL ... so we recently had a shock… when AIM-HIGH was stopped because [there was] no evidence of benefit."
~ Daniel Rader, MD

The Medical Roundtable Cardiovascular Edition Vol 3 Iss 4

"I would like to say there are many patients who get treated with clopidogrel. This applies to the PLATO trial as well. Since 46% of patients in the PLATO trial had already received clopidogrel administered in-hospital before getting randomized,2 a clinician can still safely load with ticagrelor 180 mg followed by 90 mg twice daily."

Carl J. Lavie, MD

The Medical Roundtable Cardiovascular Edition Vol 1 Iss 4

“I really feel conceptually, and, I guess, philosophically, that ablation can have major favorable effects on peoples’ lives, even in addition to symptom control.”
~ David Callans, MD

The Medical Roundtable Cardiovascular Edition Vol 3 Iss 4

"The [recently published new] guidelines incorporate other risk factors that can further identify those at intermediate risk—patients who would benefit from oral anticoagulation instead of aspirin."
~ Annabelle Volgman, MD

The Medical Roundtable Cardiovascular Edition Vol 2 Iss 3

“There are a lot of patients who can’t tolerate the higher dose of a statin, and maybe even ... on an every-other-day basis. Then we have to use the other agents that are at our disposal, whether it’s extended release niacin, ezetimibe, a resin, and/or fenofibrate.”
~ Roger S. Blumenthal, MD

The Medical Roundtable General Medicine Edition Vol 1 Iss 3

"Obstructive sleep apnea (OSA) is increasingly recognized as a significant public health problem. Recent research has shown that it is related to a number of common medical illnesses such as hypertension, cardiovascular disease, and diabetes."

Stuart F. Quan

The Medical Roundtable General Medicine Edition Vol 1 Iss 4

"Over the last 2 decades, professional organizations have issued a number of screening guidelines. Initially, the AUA and ACS were very pro-screening. However, over time, they have acknowledged the fact that screening decisions are complicated, involving tradeoffs between benefits and harms, and that we need to help men make informed decisions."

Richard Hoffman

The Medical Roundtable Cardiovascular Edition Vol 3 Iss 4

"Provided that we currently use only second- or, maybe in Europe, third-generation drug-eluting stents, I would prescribe a minimum of 6 months of DAPT, and I don’t make a strong effort to prolong DAPT over 6 months."

~ Antonio Colombo, MD

The Medical Roundtable Cardiovascular Edition Vol 1 Iss 1

I wrote … that the pen, and namely the prescription pad, may be mightier than the stent. I’ve gotten quite a reaction from that, being an interventional cardiologist.
-Spencer King, MD

The Medical Roundtable Cardiovascular Edition Vol 3 Iss 2

"Certainly, the procedure is performed safely in this study. There were no significant adverse events... In fact, there were fewer events, albeit ... significant in terms of the overall mortality."
~ Vivek Reddy, MD

The Medical Roundtable Cardiovascular Edition Vol 2 Iss 4

“Are we ready to make clinical decisions based on the presence of a scar in a patient with dilated cardiomyopathy and no coronary disease?”
~ Javier Sanz, MD

The Medical Roundtable General Medicine Edition Vol 1 Iss 2

"When untreated or unsuccessfully treated, these attacks typically last 4 to 72 hours. Migraine varies widely in frequency, severity, and impact on the patient’s quality of life."
~Brian Grosberg

The Medical Roundtable General Medicine Edition Vol 1 Iss 3

"In my opinion, any patient who has had a history of episodic migraine and then has headaches on more than 15 days a month or more than half the time, should be considered for onabotulinum toxin A."

Sheena K. Aurora

The Medical Roundtable Cardiovascular Edition Vol 1 Iss 4

“In essence, there can be some disconnect between what one’s heart function is at baseline and the precipitant that leads to acute decompensation.”
~ Phillip Levy, MD

The Medical Roundtable Cardiovascular Edition Vol 2 Iss 4

“You discuss with your patient what the available knowledge is, even though it’s limited, and you make the decision together.”
~ David Callans, MD

The Medical Roundtable Cardiovascular Edition Vol 1 Iss 2

“Because of socioeconomic limitations [our patients] are not always compliant about their medicines and follow-up, so we tend to err on the side of implanting sooner.”
-Richard Trohman, MD

The Medical Roundtable Cardiovascular Edition Vol 3 Iss 4

"[One of the important questions that the results of galectin-3 testing raises is ‘should we be starting aldosterone blockers immediately in the patient presenting with acute heart failure and preserved ejection fraction?’]"

Frank Peacock, MD

The Medical Roundtable General Medicine Edition Vol 1 Iss 3

"Knowing that efficacy is not 100% and that comorbidities can add to a poor response, we realize that some patients need to move on to second-line therapies."

Charles Butrick

The Medical Roundtable General Medicine Edition Vol 1 Iss 4

"When I put a patient on an NSAID, …. I’m careful to ask the patients about bleeding and to warn them about the signs of GI bleeding, and I do periodic blood counts to look at hemoglobin and creatinine levels. I also do a urinalysis to rule out silent GI or renal effects of these drugs, but I do use NSAIDs frequently."

Eric Gall

The Medical Roundtable Cardiovascular Edition Vol 1 Iss 3

“The use of the plasma aldo to renin ratio is a source of considerable confusion …the ratio is irrelevant as a screening test for primary aldosteronism.”
~ Norman Kaplan, MD

The Medical Roundtable General Medicine Edition Vol 1 Iss 3

"We now know that sleep and the sleep/wake cycle are intertwined with most of our bodily systems, so sleep problems can lead to pathologies in many different physiological systems, possibly causing acute and chronic effects."

David Neubauer

The Medical Roundtable Cardiovascular Edition Vol 2 Iss 1

“...the value of performing a Valsalva procedure cannot be underestimated when using agitated saline for the detection of a right to left shunt.”
~ Michael Main, MD

The Medical Roundtable Cardiovascular Edition Vol 3 Iss 3

"If you look at the curve of the decrease in mortality from heart disease for the past 50 years in this country, there is a steady downtrend. But when we break up the data … it indicated that women did not benefit until the last decade."
Ezra A. Amsterdam, MD

The Medical Roundtable Cardiovascular Edition Vol 3 Iss 4

"I believe there has been a natural progression to spiraling costs. Despite what has or has not been achieved up to this point with reform, we have reached a crisis regarding out-of-control costs, and something must be done about it."

Christopher Pastore, MD

The Medical Roundtable Cardiovascular Edition Vol 1 Iss 3

“Most of the time we’re talking about an absolute difference in diabetes incidence within these trials of a couple percent.”
~ Bill Cushman, MD

The Medical Roundtable General Medicine Edition Vol 1 Iss 3

"One thing that I notice…is the lack of attention to IBS compared to Crohn’s disease and other GI disorders.…The unpredictability of IBS and its symptoms really affects the quality of life more than we give it credit for, in comparison to diseases that may have a greater impression on the doctor because they are associated with inflammation."

Mark Pimentel

The Medical Roundtable Cardiovascular Edition Vol 1 Iss 1

“Troponin was a pretty good test when it was a crappy assay, but now that it’s a good assay, it’s a crappy test.”
-Bob Jesse, MD, Chairman of Medicine, Veteran's Administration, as quoted by W. Frank Peacock, MD

The Medical Roundtable General Medicine Edition Vol 1 Iss 1

“The NIH State-of-the-Science Conference concluded that [antipsychotics and barbituates] have significant risks and cannot be recommended for the treatment of insomnia. So I think that’s important for clinicians to remember.”
~ Sonia Ancoli-Israel

The Medical Roundtable General Medicine Edition Vol 1 Iss 2

"These trials have enrolled more than 50,000 patients, so we have a great foundation of information not only about AF but also about the drugs."
~Ken Mahaffey

The Medical Roundtable General Medicine Edition Vol 1 Iss 3

"HIV clinicians often spend more time addressing comorbid chronic illnesses such as diabetes, cardiovascular disease, mental health and substance disorders, liver disease, and cancer than managing antiretrovirals or opportunistic infections."

Todd Korthuis

The Medical Roundtable General Medicine Edition Vol 1 Iss 2

"Fibromyalgia is undoubtedly a valid condition characterized by widespread body pain as well as variable other symptoms, which can include fatigue; sleep disturbance; mood disorders; and other somatic symptoms such as headache, abdominal pain, and hypersensitivity to external stimuli. Fibromyalgia remains a clinical challenge as there is no defining test, symptoms are subjective with variable patient presentation, and ideal treatment is elusive."

Mary-Ann Fitzcharles

"We have evidence of various properties of HDL [high-density lipoprotein] that might be theoretically useful for describing its potential benefit, but we don’t have either a clinical trial or other prospective evidence indicating that any of these properties are explanatory."

John LaRosa, MD

The Medical Roundtable Cardiovascular Edition Vol 3 Iss 4

"Diastolic function might also help you identify further people who have systolic impairment by providing additional information regarding the loading condition of the patient, ie, the LV [left ventricular] filling pressure. It also provides valuable prognostic information beyond EF [ejection fraction]."

Rami Doukky, MD

The Medical Roundtable Cardiovascular Edition Vol 2 Iss 1

“Ezetimibe has a role for LDL cholesterol lowering when other options have been exhausted. A change in this approach will require compelling evidence from a clinical events trial.”
~ Robert S. Rosenson, MD

The Medical Roundtable Cardiovascular Edition Vol 1 Iss 2

“…it’s difficult for me to think that FAIR-HF proves that giving iron in any form would necessarily be beneficial.”
-Stephen S. Gottlieb, MD

The Medical Roundtable Cardiovascular Edition Vol 2 Iss 4

“So, do you think that ED is caused by HF or do you think it's just an association of two conditions with identical risk factors?”
~ Ernst R. Schwarz, MD, PhD

The Medical Roundtable Cardiovascular Edition Vol 1 Iss 3

“Various studies have shown that [with complementary and alternative therapies] the patient’s satisfaction is markedly increased, and there is a shortening of the length of the hospital stay.”
~ Gulshan Sethi, MD

The Medical Roundtable Cardiovascular Edition Vol 1 Iss 1

Although the two drugs lowered central pulse pressure in the brachial artery to the same degree, nebivolol lowered central pulse pressure more than atenolol.
-John Cockcroft, MD

"...we all agree that one of our strong recommendations from this particular discussion is going to be that every institution should have a protocol for the basic framework of applying these treatments for ACS."

Christopher B. Granger, MD

The Medical Roundtable Cardiovascular Edition Vol 2 Iss 2

“We have substantial outcomes data with spironolactone and eplerenone; eplerenone in the post-MI patient, spironolactone more so in the Class III or Class IV heart failure patient. Clearly there has been a renaissance for the drugs.”
~ Bill Frishman, MD

The Medical Roundtable Cardiovascular Edition Vol 1 Iss 2

“Some tend to use sildenafil as a starting agent since there is evidence of symptomatic and functional benefit. However, this remains controversial.”
-Patricia A. Uber, PharmD

The Medical Roundtable Cardiovascular Edition Vol 2 Iss 1

“Atrial fibrillation always looks essentially the same on the ECG, but it’s certainly not one disorder.”
~ James Reiffel, MD

The Medical Roundtable Cardiovascular Edition Vol 3 Iss 1

"So in someone who’s in his 70s, do you think we are where we can say that one really ought to turn to destination therapy VADs?"
~ James Young, MD

The Medical Roundtable Cardiovascular Edition Vol 1 Iss 4

“I always worry that we haven’t had the patients in there long enough to finally tidy up their drugs, particularly the diuretics, to make sure they understand instructions.”
~ Ileana Piña, MD

The Medical Roundtable Cardiovascular Edition Vol 3 Iss 2

"That’s ... one way of using what appears to be an unsophisticated maneuver to gain fairly sophisticated insight into the volume status of the patients."
~ Douglas Schocken, MD

The Medical Roundtable Cardiovascular Edition Vol 1 Iss 2

“…many of our clinicians get caught up in the diagnosis of coronary disease... I strongly believe that this is not the purpose of the ED evaluation.”
-Michael Farkouh, MD, MSc

"I don’t believe that a good guideline should be hidebound by unduly restrictive ‘evidence rules’ that ignore all but a tiny fraction of the available scientific information. A good guideline must synthesize complex data in a clear and concise way and must address the kinds of questions that real doctors need answered every day."

Joseph L. Izzo, Jr., MD

The Medical Roundtable General Medicine Edition Vol 1 Iss 3

"According to the ACC/AHA guidelines, routine exercise testing in the asymptomatic patient is a class III indication and therefore not recommended because the information you get is going to be more confusing and may lead to unnecessary further testing that could lead to complications."

Joseph Alpert

The Medical Roundtable Cardiovascular Edition Vol 3 Iss 2

"I recommend to people who want to take home BPs, do it with a protocol. They take their BP twice a day for two weeks and that’s recently been shown to be all you really need."
~ Henry Black, MD

Therapeutic Portfolio