Clinical
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Pressure Support vs. T-Piece Trials for Successful Extubation: An End to the Controversy?
In a randomized clinical trial of 1,153 adults who were ready for weaning after at least 24 hours of mechanical ventilation, researchers found that a spontaneous breathing trial with 30 minutes of pressure support ventilation compared with two hours of T-piece ventilation led to significantly higher successful extubation rates.
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Critical Care in the Obese Patient
This article will highlight some important practical aspects of care that arise in the management of critically ill obese patients, along with the unique physiology resulting from obesity.
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Bempedoic Acid (Nexletol)/Bempedoic Acid and Ezetimibe (Nexlizet)
Bempedoic acid and bempedoic acid/ezetimibe should be prescribed as a supplement to diet and maximally tolerated statin therapy in adults with heterozygous familial hypercholesterolemia or established atherosclerotic cardiovascular disease who need additional LDL-C lowering.
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Heart Rate and Diastolic Blood Pressure in Chronic Aortic Regurgitation Patients
A retrospective observational study of patients with moderate to severe aortic regurgitation showed the independent predictive value of diastolic blood pressure and resting heart rate for all-cause mortality under medical management.
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Using Apple Cider Vinegar for Weight Management on a Restricted Diet
Supplementation with 30 mL of apple cider vinegar combined with a restricted calorie diet may lower body weight, body mass index, and serum triglyceride levels in people with obesity.
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Are Epidural Steroid Injections Cost-Effective?
In a retrospective review of patients treated for low back pain and lumbar radiculopathy at the Cleveland Clinic, at three- and six-month follow-up, epidural steroid injections were no better than conservative therapies in quality of life measures or overall cost of medical care.
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Incidence of Cardiovascular Disease and All-Cause Mortality: Does the Type of Meat Consumed Matter?
Investigators found consuming more processed meat, unprocessed red meat, or poultry (but not fish) was closely connected to a higher risk for incident cardiovascular disease. Meanwhile, consuming processed meat or unprocessed red meat (but neither fish or poultry) was strongly associated with a higher risk of all-cause mortality.
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Heart Failure Confers Increased Risk of Venous Thromboembolic Events
In the Atherosclerosis Risk in Communities (ARIC) cohort, incident heart failure hospitalization with either preserved or reduced ejection fraction was associated with long-term increased risk of venous thromboembolic events.
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Role of Cardiac MRI in Recurrent Pericarditis
This multicenter study revealed cardiac MRI may be useful in the diagnosis of difficult pericarditis cases, especially if pericardial edema and late gadolinium enhancement are found. Pericardial thickening and elevated C-reactive protein were found to be predictive of recurrent pericarditis and other complications.
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Anatomic vs. Functional Testing in Older Coronary Artery Disease Patients
An analysis of the PROMISE trial by age showed that cardiovascular death or myocardial infarction was predicted by a positive stress test in patients with symptoms suggesting myocardial ischemia who were >age 65 years, but only CT angiography or a calcium score was predictive in symptomatic patients < age 65 years.