Cardiology
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More ICU Care Does Not Equal Better Survival for Elderly Patients
With an aging population and growing numbers of ICU beds, the question arises as to whether the ICU truly is beneficial for this vulnerable population. To explore this question, a cluster-randomized, clinical trial was designed to determine whether a method of systematic ICU admission in critically ill elderly patients reduced six-month mortality.
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Noninvasive Ablation of Ventricular Tachycardia: A Paradigm Shift?
In five patients with recurrent ventricular tachycardia refractory to conventional therapies, relatively short treatments with electrophysiology-guided stereotactic body radiation therapy were highly effective at reducing arrhythmia burden.
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Follow-up Blood Cultures in Gram-negative Bacteremia — Don’t Order Them
Not only does ordering routine follow-up blood cultures in patients with GNR bacteremia seldom produce helpful information, but common false-positive results can lead to longer length of stay, additional inappropriate antibiotic therapy, and increased healthcare costs.
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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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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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Assessing Device-assisted CPR Safety
A randomized, prospective, noninferiority study of the safety of two automated CPR devices (LUCAS and AutoPulse) against the standard manual chest compressions in cardiac arrest victims showed that in cases of severe or life-threatening complications, the LUCAS device was noninferior to standard CPR, but more organ damage with the AutoPulse cannot be excluded.
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Research Provides More Support for Antiplatelet Therapy De-escalation
The authors of a single-center study randomized post-acute coronary syndrome patients either to remain on higher-potency antiplatelet agents or to change to clopidogrel after one month. The results showed a benefit to de-escalation in terms of both bleeding and ischemic events, regardless of initial platelet reactivity.
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Clinical Briefs
In this section: Finding the prescription for the best diet, treating severe acute pain in the ED, and reducing falls among older patients.
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Ertugliflozin Tablets (Steglatro)
Ertugliflozin is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus.
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The Incidence of Dementia May Be Declining
In community-dwelling people from Bronx County, New York, there was a sharp decrease in dementia incidence in those born after mid-1929, which could not be readily explained by changes in the prevalence of cardiovascular diseases, higher education, or increased racial/ethnic diversity.