Clinical
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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.
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Auditory Startle Response as a Predictor of Recovery from Coma
Preserved habituation of the auditory startle response, performed bedside, indicates intact cortical structures and cortico-cortical white matter tract connections. Preservation of this reaction in patients with unresponsive wakefulness can help distinguish the vegetative state from minimally conscious state and may even predict eventual awakening.
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Oral Calcitonin Gene-Related Peptide Antagonist for Migraine Prevention
Atogepant, an oral calcitonin gene-related peptide antagonist, was shown to be effective and safe for migraine prevention.