Triumph Over Tragedy: The Odyssey of an Academic Physician

Triumph Over Tragedy: The Odyssey of an Academic Physician is the remarkable new memoir written by William H. Frishman, M.D., currently the Director of Medicine at Westchester Medical Center and the Rosenthal Professor and Chairman of the Department of Medicine at New York Medical College in Valhalla, New York, positions he has held for almost 20 years. Dr. Frishman is a devotee of history and literature, and The Odyssey by Homer is one of his favorite books. In Triumph Over Tragedy, he details his own personal odyssey, and relays his experiences, through text and photos, as a son, student, soldier, doctor, teacher, husband, father and academic leader. A prolific writer and researcher, Dr. Frishman has participated in the development and editing of over 1,000 academic articles and 14 full-length textbooks. In Triumph Over Tragedy, he provides a personal account of how his early experiences, and personal family tragedies, shaped his life and career

Readmissions in Adult Patients Following Hospitalization for Influenza: A Nationwide Cohort Study

BACKGROUND: Influenza epidemics are a major health care concern in the US. Influenza related complications can increase in-hospital complications, and readmissions following a hospitalization for influenza. We sought to determine the 30-day readmission rate, etiologies, outcomes, and healthcare burden of 30-day readmissions in adults hospitalized for influenza. METHODS: The 2014 US National Readmissions Database (NRD) was retrospectively analyzed to identify patients ≥18 years of age hospitalized for influenza and discharged between January and November 2014. We used this time frame as this was the most recent data available for analysis and included patients who had 30-day follow-up. Survey design based multivariable logistic regression models were used to identify factors associated with a 30-day readmission. RESULTS: Of the 46,117 patients who were hospitalized for influenza and survived to discharge, 4,721 (10.2%) patients had 5,275 30-day readmissions, estimated to 11.4 readmissions per 100 patients. Non-influenza pneumonia was the most common etiology of 30-day readmissions (10.4%) followed by sepsis (9.8%). The median costs of readmissions were $8,538 (IQR,$5,053-15,262), which were significantly higher than the median costs of their index hospitalizations [$7,863 (IQR,$4,875-13,212); P\u3c0.001]. Around 6.5% of the patients died during a readmission. CONCLUSIONS: Adult patients hospitalized for influenza had 11.4 30-day readmissions per 100 patients, most commonly for non-influenza pneumonia. Thirty-day readmissions were associated with higher costs of care and considerable mortality

Controlled-release carvedilol in the management of systemic hypertension and myocardial dysfunction

Cardiovascular disease is the leading cause of death worldwide. Within the treatment armamentarium, beta-blockers have demonstrated efficacy across the spectrum of cardiovascular disease – from modification of a risk factor (ie, hypertension) to treatment after an acute event (ie, myocardial infarction). Recently, the use of beta-blockers as a first-line therapy in hypertension has been called into question. Moreover, beta-blockers as a class are saddled with a misperception of having poor tolerability. However, vasodilatory beta-blockers such as carvedilol have a different hemodynamic action that provides the benefits of beta-blockade with the addition of vasodilation resulting from alpha 1-adrenergic receptor blockade. Vasodilation reduces total peripheral resistance, which may produce an overall positive effect on tolerability. Recently, a new, controlled-release carvedilol formulation has been developed that provides the clinical efficacy of carvedilol but is indicated for once-daily dosing. This review presents an overview of the clinical and pharmacologic carvedilol controlled-release data