Cardiology
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Right Heart Failure in the ICU
Right ventricular (RV) failure continues to be a formidable clinical challenge in critical care medicine. Regardless of the etiology, pulmonary hypertension and RV failure carries a poor prognosis. Prompt identification and treatment is warranted. Unfortunately, there is considerable lack of evidence in the management of RV failure in the medical ICU. Most recommendations are based on expert opinion or low-quality evidence.
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Fluticasone Furoate, Umeclidinium, and Vilanterol Inhalation Powder (Trelegy Ellipta)
Trelegy Ellipta is indicated for the long-term maintenance treatment of patients with COPD, including chronic bronchitis and/or emphysema.
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Clinical Briefs
In this section: Some good news for type 2 diabetes patients; hormone replacement during menopause; and chasing an unusual rosacea lead.
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Functional Outcomes After Receiving Life-sustaining Therapy in the ICU
Among patients who have spent at least three days in an ICU and required even brief mechanical ventilation and/or vasopressor support, almost half are dead and only one-third return to their baseline at six months. Several factors present on the first day of admission are associated with not returning to baseline status.
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Irritable Bowel Syndrome, Constipation, and Quality of Life in Women
Irritable bowel syndrome has a negative effect on women’s quality of life and affects one-third of women who present for care with fecal incontinence.
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Antibiotics and Adverse Events: Doctors, Do No Harm
A retrospective study found that among 1,488 hospitalized patients who received an antibiotic, 298 experienced at least one antibiotic-associated adverse drug event. Furthermore, 287 of the antibiotic regimens were not clinically indicated, and 56 of these were associated with an adverse drug event.
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Are Right-sided Leads Needed?
The ECG in the figure was obtained from a man in his 50s who presented with new severe chest pain. How would you interpret this tracing? What area(s) of the heart are involved? What is the likely culprit artery?
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Clinical Briefs
In this section: opioid-induced nausea; considering the safety of proton pump inhibitors; and life after bariatric surgery.
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Secnidazole Oral Granules (Solosec)
Secnidazole is indicated for the treatment of bacterial vaginosis in adult women.
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Oily Fish Is Associated With Better Sleep
A study in Ecuador showed a strong positive correlation between dietary oily fish intake and sleep quality.