Cardiology
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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.
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.
Oncologists and Intensivists Perceive Prognosis Differently for Critically Ill Patients With Cancer
When considering prognostication or limitation of care in critically ill patients with different cancers, oncologists may focus on cancer characteristics, whereas intensivists may focus on multiple organ failure.
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.
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.
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.
Clinical Briefs
In this section: Some good news for type 2 diabetes patients; hormone replacement during menopause; and chasing an unusual rosacea lead.
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.
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.
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.