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Anticoagulation Management After Intracerebral Hemorrhage in Mechanical Heart Valve Patients
An observational study of patients with mechanical heart valves on oral anticoagulants who had an intracranial hemorrhage demonstrates that it generally is safe to resume anticoagulants after 14 days. However, in high-risk-for-thromboembolism patients, such as those with atrial fibrillation, restarting anticoagulants six to 13 days postoperative may be considered.
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When Can Surgeons Perform Aortic Valve Replacement Safely After a Stroke?
Interrogation of Danish administrative registry data demonstrated that a stroke within three to four months of aortic valve surgery was associated with a higher rate of perioperative stroke.
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Tailored Anticoagulation for Paroxysmal Atrial Fibrillation
Intermittent anticoagulation guided by continuous assessment of arrhythmia status in patients with low-to-moderate risk did not result in any strokes or thromboembolic events over a relatively short follow-up period. Such a strategy may be an alternative to chronic anticoagulation but requires further study.
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Invasive Procedures and the Risk of Infective Endocarditis
This large study suggests that several invasive, nondental medical procedures may be triggers for subsequent infective endocarditis, reopening the debate regarding prevention and management.
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Choosing a Vasopressor in Cardiogenic Shock: Is There a Difference?
When studying cardiogenic shock after acute myocardial infarction, these investigators found using epinephrine compared to norepinephrine produced similar effects on blood pressure and cardiac index, but resulted in a higher incidence of refractory cardiogenic shock.
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Infectious Disease Alert Updates
Worse Than Snake Oil; Contract Tracing Using WHO Network; Preparing Your Hospital for Candida auris
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Re-evaluating Steroid Therapy in Septic Shock
Two recent trials have provided more data regarding steroid therapy for septic shock.
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Encephalitis, Fever, and Doxycycline
Scrub typhus is a significant cause of acute encephalitis in north India and other parts of Asia and Africa. Doxycycline is a safe and effective treatment option.
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The Viral World Keeps on Going — Some Recent Activity
Ebola makes a comeback, but meets a vaccine. Lassa fever and Rift Valley fever also make their mark, while Keystone virus infects a teenager in Florida.
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Using Multilocus Sequence Typing for Surveillance and Discovery of Borrelia Species
Broad polymerase chain reaction screening followed by multilocus sequence typing is a useful method to understand the geographic distribution of Borrelia species causing human disease. Candidatus B. johnsonii (carried by bat ticks) was not known previously to infect humans. Its identification in a human patient suggests it may cause a relapsing fever syndrome.