Articles Tagged With:
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Appropriate Management of Thoracic Aortic Aneurysms
Among patients with arch and descending thoracic aorta aneurysms followed over a mean of 20 months, aneurysm-related mortality was predicted by the size and growth rate of the aneurysms, along with age and sex.
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Remaining Questions in Syphilis Treatment
Eight leading experts on sexually transmitted diseases convened to discuss key questions in the management of syphilis in adults with and without HIV infection based on a systematic review of the literature. More than 3,000 articles were screened, and the discussion focused on 95 relevant publications and three main topics.
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Betibeglogene Autotemcel Suspension (Zynteglo)
The FDA has approved the first cell-based gene therapy to treat adult and pediatric patients with beta-thalassemia who require regular blood transfusions.
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Hot Trials from the European Society of Cardiology Annual Congress
Below are some highlights from four key studies presented in Barcelona, Spain, between Aug. 26 and Aug. 29, 2022, along with Dr. Crawford’s personal commentary on each.
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REVIVED Shows No PCI Benefit for Patients with Coronary Disease, Reduced EF
Researchers randomly assigned patients with an ejection fraction ≤ 35% and severe coronary disease to percutaneous coronary intervention or optimal medical therapy alone. After 3.4 years median follow-up, researchers noted no significant differences between groups in terms of all-cause death or heart failure hospitalization.
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Statins Plus Ezetimibe vs. Statins Alone
A comparison of rosuvastatin 10 mg/day plus ezetimibe (10 mg/day) to 20 mg/day of rosuvastatin alone showed non-inferiority in three-year major cardiovascular outcomes, with lower LDL cholesterol levels and fewer episodes of drug discontinuation or dose reductions in the combination therapy group.
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Importance of Discordant Grading of Moderate Aortic Stenosis
A study of patients with moderate aortic stenosis by Doppler echocardiographic calculated valve area revealed 40% exhibit discordant measures, where pressure gradient is lower than expected. These patients died more often than those with concordant measurements, especially those where the discrepancy was caused by low flow.
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Fraud Allegations Involving Alzheimer’s Disease Study Raise Concerns
In a paper published in 2006, the authors provided evidence indicating accumulation of a specific form of beta-amyloid protein was a cause of Alzheimer’s disease. However, recent accusations suggest images allegedly were altered, raising doubts about the initial conclusions. Regardless of what happened, this case has jumpstarted a conversation about instituting more preventive measures, conducting faster investigations into fraud allegations, and levying more severe consequences for researchers found guilty of misconduct.
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Ethicists Asked to Weigh in on Medical Necessity of Abortion
If ethicists are asked to weigh in, they should suggest a second medical opinion (if time permits) and encourage the institution to clarify any legal questions, ideally before there is an emergency. Institutions also should assure clinicians they will have support from the ethics committee in the event of overzealous prosecution.
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New Requirements Are Discouraging Physicians from Writing DNR Orders
Ethicists should help develop related protocols. For practitioners, code status conversations should be treated with the seriousness of surgery. That means involving the right people and taking the time to ensure medical understanding and prognosis, as well as patient values and goals, before talking about a care plan. When possible, practitioners should bring up DNR at the end of a meaningful conversation.