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Tirzepatide Injection (Zepbound) for Obstructive Sleep Apnea
The U.S. Food and Drug Administration has approved tirzepatide for the treatment of moderate-to-severe sleep apnea in adults with obesity.
Clostridioides difficile: Reduced Susceptibility to Vancomycin?
Many sites have been reluctant to prescribe fidaxomicin as the first-line agent, despite fairly robust evidence indicating its efficacy relative to vancomycin in preventing recurrences. We still cannot predict who will do well with vancomycin and which patients are likely to relapse or to do more poorly. The gradual emergence of Clostridioides difficile with reduced vancomycin susceptibility may contribute to adverse outcomes when using this agent.
Antiplatelet Therapy for Coronary Stent Patients Undergoing Noncardiac Surgery
A larger randomized controlled trial of aspirin monotherapy vs. no antiplatelet therapy in patients more than one year post-drug-eluting coronary stent placement failed to show a difference in ischemic outcomes or major bleeding, but minor bleeding was more common in the aspirin group.
Arrhythmias in the Holiday Heart Syndrome
A small study of continuous electrocardiogram and breath alcohol concentration in young volunteers during acute excessive alcohol consumption has shown that heart rate and ventricular premature beats increased during the drinking period. During recovery (six to 19 hours), significant arrhythmias such as atrial fibrillation occurred in 5% of the subjects. The observed changes in heart rate variability and breath alcohol concentration suggest that these effects are the result of increased sympathetic nervous system activity associated with excessive blood alcohol concentrations.
Reduced Control and Workplace Burnout
This cross-sectional study of more than 2,000 physicians from diverse healthcare organizations found that reduced control over specific aspects of practice — such as patient load, clinical hours, and overall workload — was significantly associated with not only higher levels of burnout, but also increased intentions to reduce clinical hours or leave practice altogether.
Unhurried Patient Care
Unhurried conversations during patient encounters can improve outcomes for patients and enhance career satisfaction of physicians. Specific communication strategies can foster unhurried conversations without adding undue time to clinical care.
Burnout in the Emergency Department
This article examines the unique challenges of burnout in emergency department providers, exploring its impact on individuals, teams, and patient care. After an overview of the phenomenon, including historical trends and current statistics, this article will discuss actionable strategies to mitigate burnout and foster resilience, illustrated through real-world experiences of emergency medicine professionals.
Constipation in Adults and Children
Constipation is a common diagnosis that has been steadily increasing in prevalence over the past several decades. As the morbidity and healthcare costs from this condition increase, it is important that physicians be aware of the workup, management, and potential complications of this common condition in adults and children alike.
Clinical, Biological, and Imaging Features of Intravascular Large B-Cell Lymphoma
A multicenter, retrospective cohort study of 17 patients with pathology-proven intravascular lymphoma involving the central nervous system identified “red flag” clinical features, imaging patterns, and cerebrospinal fluid characteristics that may help expedite the diagnosis of this rare, complex, and deceptive disease.
ABCD2 Score as a Predictor of Three-Year Stroke Risk
This retrospective cohort study using the National Patient Registry in Denmark analyzed a three-year follow-up period following a transient ischemic attack, looking at the rate of recurrent stroke and mortality. The patients were divided into low risk (ABCD2 score 0-3) and high risk (ABCD2 score ≥ 4). The stroke rate was 6% in the high-risk group and 4% in the low-risk group.