Clinical
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Prophylactic PCI for Vulnerable Plaques
In this proof-of-concept trial, treatment of non-flow limiting vulnerable plaque by PCI with bioabsorbable stents resulted in no significant difference in lesion-related events compared with optimal medical therapy, but there was a trend toward less angina driven revascularization in the stented group.
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Does Epidural Analgesia for Labor and Delivery Pain Relief Cause Autism?
In this retrospective cohort study of 147,895 singleton births, epidural anesthesia was used in 74.2% of cases and the hazard ratio for the subsequent diagnosis of autism spectrum disorders was 1.37 (95% confidence interval, 1.23-1.53).
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Are Anti-Inflammatory Drugs Useful in Malignant Pericardial Effusion?
Researchers studied patients with malignant pericardial effusion treated with pericardiocentesis and then anti-inflammatory agents if signs of adhesions or constriction were observed in post-drainage echocardiograms. Compared to NSAIDs and steroids, the authors found colchicine administration for 60 days reduced the rate of subsequent all-cause mortality and recurrent pericardial effusion.
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Using Sacubitril/Valsartan to Treat Heart Failure with Preserved Ejection Fraction
An analysis of renal outcomes in the PARAGON-HF trial revealed sacubitril/valsartan slows progression of kidney disease in patients with heart failure with preserved ejection fraction compared to valsartan alone.
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The Effect of Age on Cholesterol-Lowering Therapy
Investigators analyzed data on the effect of age on cardiovascular (CV) outcomes and LDL cholesterol-lowering by alirocumab vs. placebo in recent acute coronary syndrome patients. They found alirocumab can lower the rate of CV events regardless of age — and produce increasing absolute benefit with age.
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Another Affirmation for Rhythm Control in Atrial Fibrillation
A rhythm control strategy implemented less than one year after atrial fibrillation diagnosis was associated with significant reduction in adverse cardiovascular outcomes when compared to usual care.
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Hospital Reduces High Cesarean Delivery Rate to Below Average
The American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine both recognize cesarean deliveries can save lives, but they advise vaginal deliveries for most pregnancies because the risk is lower than that of cesarean deliveries. The cesarean delivery rate is considered a key indicator of quality and patient safety. Leapfrog reported the average cesarean rate nationwide in 2018 was 26.1%, although the organization set a target of 23.9%.
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Is There Right Ventricular Strain or Acute Pulmonary Embolism?
The ECG in the figure was obtained from a middle-age woman who presented with new dyspnea. Is the T wave inversion in the inferior leads a reflection of right ventricular “strain” from acute pulmonary embolism? If not, what else might cause these ECG findings?
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COVID-19 Vaccine Update
There are dozens of vaccine candidates undergoing investigation in human and animal trials. Only a few have reached Phase III testing. This is a closer look at those.
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Gut Microbiome in Patients at Risk for Parkinson’s Disease
Certain risk factors and prodromal markers of Parkinson’s disease (PD), such as constipation and rapid eye movement sleep behavior disorder, are associated with specific bacterial compositions of the gut. However, the value of gut microbiome data to predict the risk of PD development needs further investigation.