Articles Tagged With:
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A New Technique for Predicting Outcomes in Asymptomatic AS
An international study of patients with moderate or asymptomatic severe aortic stenosis has demonstrated that increased amounts of left ventricular fibrosis, as measured by cardiac magnetic resonance imaging, is associated with worse outcomes.
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PCI in TAVR Patients with Severe Coronary Lesions Shows Benefits
In this randomized trial of patients undergoing transcatheter aortic valve replacement (TAVR), with an average of one severe coronary stenosis, percutaneous coronary intervention in addition to TAVR reduced the incidence of the combined endpoint of all-cause mortality, myocardial infarction, and urgent revascularization at two years.
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Screening for Atrial Fibrillation in Older Adults
A two-week ambulatory electrocardiogram monitor in a large group of individuals 70 years of age or older with no history of atrial fibrillation (AF) showed a very low incidence of AF (4.4%), almost all of which was paroxysmal. In less than 2% of the subjects did it represent ≥ 2% of the monitoring time. However, some patients had hours of AF, raising a concern for thromboembolic risk.
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Biomarker Enhances Screening for Atrial Fibrillation
A large Swedish population study of screening for atrial fibrillation (AF) in 75-year-old individuals that was enhanced by N-terminal pro-B-type natriuretic peptide (NT-proBNP) stratification did not identify more AF cases or prevent thromboembolic outcomes compared to unscreened control subjects. However, a low NT-proBNP (< 125 ng/L) did identify individuals at low risk for AF and thromboembolic events in whom screening could be safely forfeited.
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A New Drug for Heart Failure with Preserved Ejection Fraction?
The addition of the nonsteroidal mineralocorticoid receptor antagonist finerenone to standard therapy reduced the incidence of recurrent heart failure and death compared to placebo in patients with heart failure and mildly reduced or preserved left ventricular ejection fraction and was generally well tolerated.
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Infectious Disease Updates
ID: An Arbiter of Death? Preventing Recurrent UTI with Probiotics
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Pediatric Pneumonia, Diagnostic Uncertainty, and Communication
Community-acquired pneumonia is a common cause of hospitalization among children in resourced countries and is the leading cause of childhood death in lower-income countries. However, the diagnosis of pneumonia is fraught with uncertainty, and management practices vary widely. Clinician behaviors and attributes that engender trust in the face of diagnostic uncertainty have been documented.
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Diagnostic Uncertainty in Community-Acquired Pneumonia
A national retrospective cohort study from the Veterans Administration found a high rate of diagnostic discordance for patients admitted and discharged for community-acquired pneumonia (CAP). Improvement in the diagnosis of CAP is needed.
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Mucormycosis Remains Highly Lethal
Mucormycosis continues to be associated with a high mortality rate. Polymerase chain reaction may speed diagnosis and allow earlier initiation of therapy. There appears to be no evidence supporting the use of combination as opposed to single agent (liposomal amphotericin B) therapy.
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Outbreak of Marburg Virus Disease in Rwanda
A rising number of cases of Marburg virus disease, which is caused by one of the most virulent human pathogens, have been reported in Rwanda. Marburg virus infections in humans are rare but can present with a rapidly progressive febrile illness that can lead to multi-organ failure and shock with case-fatality rates of up to 80% to 90%.