Cardiology
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Effects of Lifestyle Modifications on the Coronary and Carotid Atherosclerotic Burden
A look at how lifestyle changes, including dietary modifications and regular exercise, impact therapy for atherosclerotic cardiovascular disease.
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Diet Sodas: Are They Really Diet?
Over the past several decades, concerns about increased sugar consumption has led some experts to recommend the use of non-nutritive sweeteners (NNSs).1
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Controversial Removal of Dietary Supplements from Retailers’ Shelves
Until sound testing methodology and retailer/government oversight is honed, clinicians and consumers should discuss the appropriateness of dietary supplement use and the choice of products from reputable companies.
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Lactobacillus casei Supplementation Improves Inflammatory Markers and Disease Activity Scores in Rheumatoid Arthritis
In this randomized, double-blind, placebo-controlled study, the probiotic strain Lactobacillus casei 01 was provided to women with rheumatoid arthritis at a dosage of 108 colony forming units for a period of 8 weeks and compared to a placebo treatment. Disease activity score and levels of the proinflammatory cytokines tumor necrosis factor-α, interleukin-6, and interleukin-12 were found to be significantly decreased at the end of the intervention. Additional parameters of state and trait anxiety were also evaluated and were not significantly altered by therapies.
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Acupuncture and Moxibustion in the Treatment of Crohn’s Disease
This randomized, placebo-controlled trial demonstrated that acupuncture and moxibustion treatment in patients with Crohn’s disease significantly improved the patient’s CD symptoms, quality of life, mucosal inflammation, serum hemoglobin, and C-reactive protein levels compared to the control group.
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Live Longer: Substitute in Whole Grains
When adjusted for possible confounding variables, this analysis of U.S. men and women found an association between higher whole grain intake and lower mortality from all causes, including cardiovascular disease, but no association for cancer mortality.
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The Disruptive Effects of Tablet Readers on Sleep Patterns
The use of light-emitting tablet devices prior to bedtime negatively impacts sleep patterns through disturbances in circadian rhythms.
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Corticosteroids in Severe Community-Acquired Pneumonia: The Controversy Continues
Treatment failure in hospitalized patients with severe community-acquired pneumonia (CAP) is associated with an excessive inflammatory response and worse outcomes. Torres and colleagues sought to determine the effect of corticosteroids in patients with severe CAP and a significant inflammatory response. In this multicenter, randomized, double-blind, placebo-controlled trial, 120 severe CAP patients with C-reactive protein (CRP) levels >150 mg/L were randomized to receive either an IV methylprednisolone bolus of 0.5 mg/kg every 12 hours or placebo. Treatment began within 36 hours of hospital admission and lasted for 5 days. Severe CAP was defined as two out of the three minor criteria independently associated with severity including PaO2 /FiO2 < 250, multilobar involvement, and systolic blood pressure < 90 mmHg, or one out of two major criteria, including a requirement for mechanical ventilation or septic shock.1 Risk class V for the Pneumonia Severity Index was also considered severe CAP.2 The primary outcome was early or late treatment failure. Early treatment failure was defined as the development of shock, need for mechanical ventilation not present at baseline, or death within 72 hours of treatment. Late treatment failure was defined as radiographic progression, persistence of severe respiratory failure, development of shock, need for invasive mechanical ventilation not present at baseline, or death between 72 hours and 120 hours after treatment.
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Neuromuscular Blockade and Successful Endotracheal Intubation
Previous studies have shown the utility of neuromuscular blocking agents for endotracheal intubation in the operating room and emergency department. However, airway management in the ICU often involves unplanned, emergent intubations under suboptimal conditions. This study asked whether NMBAs improved first attempt success of intubations in the ICU. Additionally, these authors asked whether succinylcholine or rocuronium improved first attempt success and the effects of NMBA on intubations using video laryngoscopy.
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Does Functional Ability Prior to an ICU Admission Influence Outcomes in Older Adults?
The impact of an older person’s functional status prior to experiencing hospitalization for a critical illness is difficult to determine. Given that ICU admission is generally an unplanned event, obtaining prospective evaluations of function prior to a critical illness or injury is almost impossible. Most evidence to date has utilized proxy reports for a patient’s functional status to determine what, if any, pre-ICU disability may have on an older adult’s outcomes after hospitalization for a critical illness or injury.