Cardiology
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Is There a Link Between Stopping Exercise and Depressive Symptoms?
SYNOPSIS: The authors of this review article found a suggestive link between stopping exercise and the onset of depressive symptoms in healthy adults, especially in women.
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Probiotic Use in Day Care Children
A 12-week intervention of daily supplementation with probiotics Bifidobacterium animalis subsp. lactis (BB-12) and Lactobacillus rhamnosus (LGG) 10 billion colony-forming units produced no reduction in the number of days absent from day care in Danish infants 8 to 14 months old.
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A Contemporary Review of Hypertension
Hypertension is a common and serious condition that contributes to an estimated 40% of deaths from coronary heart disease and stroke, and is the second leading cause of end-stage renal disease. Because of the importance and frequency of hypertension in primary care practices, we are devoting two issues to the subject. This issue focuses on the definition of blood pressure and current guidelines, risk factors, relationship to cardiovascular disease, blood pressure measurement, patient evaluation, and secondary causes. The next issue will cover treatments (pharmacological and non-pharmacological), initial therapy, relationship to various disease conditions (diabetes, ischemic heart disease, heart failure, chronic kidney disease, cerebrovascular disease, ischemic stroke, stroke prevention, atrial fibrillation, valvular heart disease, aortic regurgitation, sexual dysfunction), resistant hypertension, hypertensive crises and emergencies, preoperative management, and adherence strategies.
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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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Are In-hospital Deaths Related to Community-acquired Pneumonia Preventable?
This secondary analysis of data from five tertiary care centers found that among patients hospitalized for community-acquired pneumonia, very few deaths potentially were related to a lapse in in-hospital quality of pneumonia care.
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Neighborhood Socioeconomic Status Associated With Infection Risk, But Not Sepsis
Based on a large, national, prospective cohort study, lower neighborhood socioeconomic status was associated with a higher incidence of hospitalizations for infection (but not sepsis) at presentation.