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Tracheostomy Patients in the Emergency Department
Tracheostomies are prone to complications. Most complications are minor and can be readily treated. Serious and life-threatening complications require prompt recognition and expeditious management.
Arrhythmia Recurrence After Catheter Ablation of Atrial Fibrillation
An integrated nationwide medical and pharmacy claims database analysis of patients with new atrial fibrillation undergoing catheter ablation as first-line therapy has shown that 17% of patients required repeat ablation for recurrent atrial fibrillation despite the frequent use of antiarrhythmic drugs.
Ten-Year Outcomes of the SCOT-HEART Study
The 10-year follow-up of the SCOT-HEART Study of new-onset chest pain patients randomized to standard care vs. the addition of coronary computed tomography angiography (CTA) has shown that coronary heart disease-related death, myocardial infarction, and other adverse cardiovascular outcomes are reduced with CTA use, perhaps because preventive therapy is increased.
Apomorphine Hydrochloride Injection (Onapgo)
The U.S. Food and Drug Administration has approved apomorphine as a constant subcutaneous infusion for the treatment of advanced Parkinson’s disease with persistent motor fluctuations. It is the second subcutaneous infusion for this indication following foscarbidopa/foslevodopa (as Vyalev).
Determinants of Long-Term Outcome After Concussion
This cohort study of U.S. veterans found that mild traumatic brain injuries occurring alongside psychological trauma are associated with long-term post-concussive symptoms and disability. The authors postulate that the traumatic context contributes to the development of post-traumatic stress disorder, which may in turn potentiate long-term sequelae.
Gabapentin vs. Duloxetine vs. Falls in Older Adults
This retrospective study examining fall risk among older adults taking gabapentin compared to duloxetine finds gabapentin users exhibit a markedly lower risk of fall-related visits at six months (hazard ratio = 0.52) yet finds no difference in the incidence of severe falls.
Clinical Insights on Managing DPN and PAD in Patients with Diabetes
Given the significant prevalence of diabetes in the population, it is important for the primary care clinician to be familiar with the many types of neuropathies commonly affecting people living with diabetes. By far the most prevalent type is chronic diabetic peripheral sensorimotor neuropathy, affecting up to 50% of people with diabetes. Peripheral arterial disease (PAD) refers to partial or complete occlusion of peripheral vessels of the lower extremities. The underdiagnosis of PAD in the primary care setting may be a major issue because of many patients presenting without the typical claudication symptoms described in medical textbooks. The ability of primary care clinicians to diagnose PAD in asymptomatic patients still has a significant clinical effect because PAD acts as a marker for systemic atherosclerosis.
Stroke 2025 Is Here!
Stroke 2025: Optimizing Outcomes with Clinical Approaches provides evidence-based, cutting edge, clinical information on treating stroke and other neurological problems in a concise, accurate, and clinically relevant format. Written and edited by leading experts in the fields of neurology and emergency medicine, Stroke 2025 is an unbiased resource for any physician or nurse working in an emergency department or stroke center. Healthcare providers can earn all of the Joint Commission-required stroke credits at one time through this electronic publication.
Clinical Consequences of Alzheimer’s and Lewy Body Co-Pathologies
This large study of patients with cognitive impairment-assessed cerebrospinal fluid biomarkers, positron emission tomography imaging, and cognitive tests showed that those with evidence of both Alzheimer’s and Lewy body pathologies had greater cognitive dysfunction and faster progression than those with either pathology alone.
Long-Term Efficacy of Ocrelizumab as First-Line Treatment for Relapsing-Remitting Multiple Sclerosis
Nine-year follow-up data from open-label extension of the Phase III clinical trials of ocrelizumab show that, although the efficacy of ocrelizumab was maintained throughout the duration of the study, patients who were treated with ocrelizumab from the beginning of the Phase III trials did better than the patients who were on subcutaneous (SC) interferon β-1a initially and were switched to ocrelizumab at the onset of the open-label extension period.