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Nonobstructive Hypertrophic Cardiomyopathy Out of the Shadows

Hypertrophic cardiomyopathy was first recognized as a disease of obstruction to left ventricular outflow, hence, its early names and acronyms such as idiopathic hypertrophic subaortic obstruction. The nonobstructive subset of patients, incapable of developing mechanical impedance to left ventricular outflow at rest or with physiologic exercise, was initially recognized by the Braunwald group at the […]

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Dr. Joseph S. Alpert

The Readmission Problem: A Modest Proposal Seeking a Solution

It is certainly no secret that patient readmissions shortly after discharge from the hospital create major healthcare and social problems today in the United States and throughout the world.1, 2, 3, 4, 5, 6, 7, 8, 9 Given our ever increasing number of elderly, frail patients in the United States, it is not surprising that many of these individuals are readmitted soon after discharge. […]

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Joseph S. Alpert

How Can We Improve the Management of Patients with Hypertension?

Hypertension continues to be a major health problem in the United States, affecting more than 76 million US citizens. Despite marked improvement in detection and therapy of patients with hypertension over recent decades, substantial morbidity and mortality still occur, especially in the Southeastern United States. Hypertension detection programs are common throughout the country and can […]

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The Tragedy of the Commons – Drug Shortages and Our Patients’ Health

  There has been, rightfully, a great deal of controversy related to the EpiPen pricing issue1; a preparation sold for $83 by Merck (Rockville, Md) a decade ago is now priced at $600. The fury directed at the company now marketing this drug-delivery device – Mylan (Canonsburg, Pa) – came from patients, families, and legislators; […]

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Joseph S. Alpert

A Sticky Problem: Dealing with Industry Under Unpleasant Circumstances

  In this issue of the American Journal of Medicine, Dr Leonard Fromer appropriately calls for easier access to potential lifesaving therapy, the epinephrine auto injector, for patients with severe allergic reactions. The editor and the staff of the AJM strongly support the concept that epinephrine auto injectors should be made affordable and easily accessible for patients who are […]

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