While the incidence of VS has remained steady, tumor size at time of diagnosis has decreased over time. Within the United States there has been a clear, recent evolution in management toward observation.

Background Adherence to evidence-based medications after myocardial infarction is associated with improved outcomes. However, long-term data on factors affecting medication adherence after myocardial infarction are lacking. Methods Olmsted County residents hospitalized with myocardial infarction from 1997-2006 were identified. Adherence to HMG-CoA reductase inhibitors (statins), beta blockers, angiotensin-converting enzyme inhibitors (ACE Inhibitors), and angiotensin II receptor blockers (ARB), were examined. Cox proportional hazard regression was used to determine the factors associated with medication adherence over time. Results Among 292 persons with incident myocardial infarction (63% men, mean age 65 years), patients were followed for an average of 52±31 months. Adherence to guideline-recommended medications declined over time, with 3-year medication continuation rates of 44%, 48%, and 43% for statins, beta blockers, and ACE Inhibitors/ARB, respectively. Enrollment in a cardiac rehabilitation program was associated with an improved likelihood of continuing medications, with adjusted hazard ratio (95% confidence interval) for discontinuation of statins and beta blockers among cardiac rehabilitation participants of 0.66 (0.45-0.92) and 0.70 (0.49-0.98), respectively. Smoking at the time of myocardial infarction was associated with a decreased likelihood of continuing medications, though results did not reach statistical significance. There were no observed associations between demographic characteristics, clinical characteristics of the myocardial infarction and medication adherence. Conclusions After myocardial infarction, a large proportion of patients discontinue use of medications over time. Enrollment in cardiac rehabilitation after myocardial infarction is associated with improved medication adherence.

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SUMMARY BackgroundDespite increasing prevalence, the economic implications of coeliac disease are just emerging.

Obesity and smoking have large long-term impacts on health care costs of working-age adults. Controlling comorbidities impacted incremental costs of obesity but may lead to underestimation of the true incremental costs because obesity is a risk factor for developing chronic conditions.

National trends of 2- versus 3-stage IPAA have remained stable over the last 5 years. Patients who underwent a 3-stage approach were healthier at the time of pouch surgery, with decreased corticosteroid use, hypoalbuminemia, and weight loss. Mixed results were seen for infectious complications with either approach. Prospective research is needed to determine the best approach to IPAA for chronic ulcerative colitis.