Cardiology
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CASTLE-AF Supports Catheter Ablation for Atrial Fibrillation in Patients with Heart Failure
Catheter ablation for atrial fibrillation in relatively young men with cardiomyopathy and heart failure is associated with a substantial reduction in arrhythmia burden, improvement in ejection fraction, and reduction in heart failure hospitalizations and mortality compared to medical therapy.
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Clinical Briefs
In this section: tackling insomnia with cognitive behavioral therapy; navigating the spurious claims of internet-advertised products; and updated guidelines regarding hypertension treatment.
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Ozenoxacin Cream 1% (Xepi)
Ozenoxacin is indicated for the topical treatment of impetigo due to S. aureus and S. pyogenes in adult patients and pediatric patients ≥ 2 months of age.
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Updated Recommendations for Prevention of Hepatitis B Virus Infection
Fresh recommendations for prevention of hepatitis B virus infection focus on testing and management of newborns.
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Functional Imaging Studies in Parkinson’s Disease
A meta-analysis of 142 studies demonstrated that functional imaging studies in Parkinson’s disease using tracers for aromatic acid decarboxylase showed smaller defects compared to those using tracers targeting dopamine transport and VMAT2. Symptom severity correlated linearly with dopamine neuron loss as determined by these imaging studies.
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A Closer Look at the Effects of NSAIDs on Blood Pressure
An ambulatory blood pressure monitoring substudy of the PRECISION trial showed that ibuprofen use significantly increased mean 24-hour systolic blood pressure compared to celecoxib. Further, naproxen produced intermediate results despite equivalent pain relief in patients with arthritis.
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Kratom Alert: FDA Concerns
Kratom, a plant that is banned in some countries, is available in the United States and has some safety concerns, mostly related to its opioid-like effects.
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Pre-existing Health Determines Quality of Life, Physical Symptoms After ICU Discharge
The authors of this nested cohort study within a randomized, controlled trial of ICU survivors requiring > 48 hours of mechanical ventilation found that pre-existing comorbidity was the main determinant of long-term health-related quality of life.
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Massive Transfusion Protocols: Recommendations Regarding Initiation and Termination
This was a narrative review of societal recommendations for initiation of massive transfusion protocols based on objective scoring systems and clinical assessment and criteria for termination of protocols.
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Implementing Restrictive Transfusion Strategies to Improve Patient Outcomes
There is extensive evidence supporting a restrictive transfusion approach in critically ill patients and cardiac surgery patients. The data favor restrictive strategies in hip and knee surgery, except in geriatric patients for whom evidence favors a more liberal transfusion strategy. Evidence is sparse in sepsis, oncology, and acute coronary syndrome patients, warranting further study.