Cardiology
RSSArticles
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Physician Burnout: A Multi-specialty Perspective
Although different specialties address the problem of physician burnout, studies suggest the most effect is gained from organizational interventions.
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Deflating Recruitment Maneuvers
Compared to the ARDSNet lower positive end-expiratory pressure (PEEP)/low tidal volume strategy, use of an “open lung ventilation” strategy consisting of aggressive alveolar recruitment maneuvers and higher PEEP is associated with higher mortality in patients with moderate to severe acute respiratory distress syndrome.
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ORBITA: Learning the Right Lessons From a Sham-controlled Trial of Angioplasty
In this sham-controlled trial of 200 patients with single-vessel coronary artery disease and stable angina, percutaneous coronary intervention did not increase exercise time significantly compared to a placebo procedure.
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Risk of Major Bleeding With Concurrent Medications in Atrial Fibrillation Patients Taking New Oral Anticoagulants
A large nationwide comprehensive clinical database showed that concomitant use of the new oral anticoagulants with amiodarone, fluconazole, rifampin, and phenytoin increases the risk of major bleeding.
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Urine Output: The New Vital Sign?
An analysis of a large ICU database showed that hourly monitoring of urine output was associated with improved detection of acute kidney injury (AKI) and lower 30-day mortality in patients with AKI.
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More ICU Care Does Not Equal Better Survival for Elderly Patients
Using a systematic strategy for promoting ICU admission for elderly patients resulted in a higher ICU admission rate but the strategy produced no effect on six-month mortality.
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Implementing Noninvasive Ventilation: If You Build It, They Will Come
Hospitals that have been highly effective in implementing noninvasive ventilation as front-line therapy for acute exacerbation of chronic obstructive pulmonary disease recognized that a combination of allied health autonomy, interdisciplinary teamwork, and devoting sufficient resources are essential features for success.
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Crystalloid Resuscitation in Sepsis and Septic Shock: The Earlier, the Better
Although the most recent Surviving Sepsis Campaign guidelines authorized completion of 30 mL/kg of IV crystalloid within three hours of the recognition of sepsis and septic shock, there remains controversy regarding the benefits and harms of early, aggressive crystalloids, especially in specific patient populations.
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Accuracy of Right Atrial Pressure Estimates by Echocardiography
Researchers compared echocardiographically determined right atrial pressure and characteristics of the inferior vena cava to right heart catheterization-measured values. They concluded that echo estimates reached through this technique should not be used clinically to estimate pulmonary artery pressure.
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CT Calcium Score vs. Stress Testing
A subgroup analysis of the PROMISE trial showed that CT coronary calcium scores in symptomatic patients at low to intermediate risk for coronary artery disease are more sensitive but less specific for major adverse cardiac events over a two-year follow-up period than stress testing. Consequently, both approaches exhibited similar but modest discriminatory ability.