Cardiology
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Neurogenesis in Older, Healthy Brains
Healthy aging allows for hippocampal neurogenesis in the brains of adults into the eighth decade of life.
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Coffin Nail for Omega-3 Fatty Acids?
A meta-analysis of 10 randomized, controlled trials of omega-3 fatty acids for the prevention of coronary heart disease and major vascular events showed no significant effect on fatal and nonfatal coronary heart disease or any major vascular event. These results do not support the use of omega-3 fatty acids supplements in patients with prior coronary heart disease.
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An International Survey of Ventilator Weaning Practices
A cross-sectional, multinational survey of adult intensivists revealed significant regional variation in several weaning practices, including screening, weaning modes, techniques to conduct spontaneous breathing trials, the use of written directives, and use of non-invasive ventilation in the peri-extubation period.
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ICU Bed Availability: Does It Make a Difference?
Nationwide, the volume of ICU admissions from the ED has increased significantly over recent years (by 50% from 2001 to 2009). When demand exceeds bed availability, complex decisions regarding ICU must be made. Does bed availability affect triage decisions? If many beds are available, patients who are too ill or too well to benefit from the ICU may be admitted. Conversely, if too few beds are available, ICU admission may be denied to patients who may benefit. In prior studies, ICU denial has been associated with increased hospital mortality.
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Is There a Role for Steroids in ARDS Management?
Mortality rates from acute respiratory distress syndrome (ARDS) remain high, even as therapy has improved over the last decade. Recent guidelines for management center on mechanical ventilation, with initial therapy beginning upon identification and treatment of the underlying cause of the ARDS. There is reasonable consensus regarding the use of lung-protective strategies, such as low tidal volume ventilation, prone positioning for those meeting criteria for severe ARDS, and restrictive fluid management after the initial resuscitation. However, for patients with the most severe disease, these treatments often are not completely effective, and we look for other therapies that might help.
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Did We Catch Vfib Onset?
Did this patient develop ventricular fibrillation (Vfib) while the ECG in the figure was recorded?
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Efavirenz, Lamivudine, and Tenofovir Disoproxil Fumarate Tablets (Symfi)
Symfi is indicated as a complete regimen for the treatment of HIV-1 infection in adult and pediatric patients weighing at least 40 kg.
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Searching for a Connection Between Silent Myocardial Infarction and Heart Failure
In a large community-based cohort, the development of silent myocardial infarction on ECG was associated with increased risk of future heart failure.
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Lower Blood Pressure Targets May Increase Mortality in Type 2 Diabetes Patients
Type 2 diabetic patients with systolic blood pressure < 120 mmHg experienced more cardiovascular events than patients with systolic blood pressure up to 140 mmHg.
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Identifying Common Traits Regarding Inappropriate Antibiotic Prescribing
In a retrospective cohort study of outpatient visits for upper respiratory infections that should not require antibiotics, researchers found several patient, practice, and provider characteristics associated with inappropriate antimicrobial prescribing. Notably, adult patients seen by an advanced practice provider were 15% more likely to receive an antimicrobial than those seen by a physician provider.