Clinical
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Dealing With Severe Acute Pain in the ED
The success of a non-opioid treatment arm in direct comparison with three opioid treatment arms should justify greater consideration of non-opioid treatment for acute severe pain.
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The Ever-elusive Prescription for the Optimum Diet
Somewhat contrary to the prevailing wisdom, intake of total fat was inversely associated with total mortality. Even the much-maligned saturated fat in the diet was associated with a reduced hazard ratio for total mortality.
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Diuretic Use in Heart Failure
For diuretic resistance, the authors endorsed continuous diuretic infusion with stepwise dose increases to achieve a 3-5 liter/day urine volume until euvolemia is achieved.
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When Gastrointestinal Complaints Are Not Prominent
In a review of patients with biopsy-proven celiac disease, those who presented with gastrointestinal symptoms exhibited a median time to diagnosis of 2.3 months, compared to 42 months for those without gastrointestinal symptoms.
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Sexual Dysfunction Among Diabetics
In a review of diabetic men and diabetic women, evaluations of sexual quality of life in both genders was meaningfully affected by partner sexual dysfunction. Perhaps not surprisingly, age and duration of diabetes were the strongest predictors of sexual dysfunction in diabetic men. The authors opined that insufficient attention has been given to the presence and effect of sexual dysfunction on the quality of life of patients and their partners.
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FDA Actions
In this section: FDA approves treatment for opioid use disorder, greenlights product to reduce cardiovascular events, gives the go-ahead to the eighth biosimilar, and approves a two-drug HIV regimen.
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Does Warfarin Prevent Cancer?
The finding that warfarin lowers the risk of cancer is plausible because warfarin inhibits AXL receptor tyrosine kinase-dependent tumorigenesis and enhances antitumor immune responses, even at doses below anticoagulation levels.
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Direct-acting Oral Anticoagulants vs. Warfarin in Atrial Fibrillation
Direct-acting oral anticoagulants are superior to warfarin for stroke prevention in atrial fibrillation, according to a new review.
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Is Ibuprofen Plus Acetaminophen as Effective as Opioids?
The authors of a recent analysis concluded that for patients presenting to the ED with acute extremity pain, there were no statistically significant or clinically important differences in pain reduction at two hours among single-dose treatment with ibuprofen and acetaminophen or three different opioid/acetaminophen combination.
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How Would You ‘Date’ This Infarct?
The ECG in the figure was obtained from a 48-year-old man who presented to the ED with a three-day history of chest discomfort. It clearly shows evidence of infarction. How would you “date” the infarct?