Clinical
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Anomalous Coronary Arteries Discovered in Middle-aged Individuals
Anomalous origin of coronary arteries from the opposite sinus are encountered more frequently in middle-aged subjects evaluated for coronary artery disease using CT angiography.
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Natriuretic Peptide-guided Therapy Does Not Improve Systolic Heart Failure Outcomes
Among high-risk patients with heart failure and reduced ejection fraction, a strategy of titrating medical therapy to a target natriuretic peptide level was not associated with improvements in hospitalization or survival.
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Rate-controlled Atrial Fibrillation as a Reversible Cause of Cardiomyopathy
In patients with persistent but rate-controlled atrial fibrillation and left ventricular systolic dysfunction of otherwise uncertain etiology, catheter ablation to restore sinus rhythm can result in significant improvement or normalization of ejection fraction.
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Is a Dabigatran Reversal Agent Effective?
A pragmatic clinical study of idarucizumab for counteracting the effects of the oral anticoagulant dabigatran showed rapid and complete reversal of its effects in patients with major bleeding or urgent surgery, without any adverse safety concerns.
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RE-DUAL Deals Another Blow to Triple Therapy
In this trial of post-percutaneous coronary intervention patients with atrial fibrillation, dual antithrombotic therapy with dabigatran and a P2Y12 inhibitor showed lower rates of bleeding but similar ischemic and thrombotic outcomes compared to a triple therapy regimen with warfarin.
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Subclinical Hypothyroidism: What Is It and When Should We Treat It?
The current diagnosis and treatment of subclinical hypothyroidism in women of reproductive age is controversial and may well change as new studies become available.
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Antenatal Steroids for Very Early PTB
A large European multicenter study has shown that antenatal corticosteroid administration in patients at risk for imminent very early preterm birth (24 to 31 weeks) will decrease perinatal mortality and morbidity substantially, even after only three hours of exposure.
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Irritable Bowel Syndrome, Constipation, and Quality of Life in Women
Irritable bowel syndrome has a negative effect on women’s quality of life and affects one-third of women who present for care with fecal incontinence.
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Do Antibiotics Reduce Hormonal Contraceptive Effectiveness?
This is a systematic review of studies evaluating the effect of concomitant non-rifamycin antibiotic use on hormonal contraceptive effectiveness. Although data are limited, there is no evidence to support the existence of drug interactions.
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Functional Outcomes After Receiving Life-sustaining Therapy in the ICU
Among patients who have spent at least three days in an ICU and required even brief mechanical ventilation and/or vasopressor support, almost half are dead and only one-third return to their baseline at six months. Several factors present on the first day of admission are associated with not returning to baseline status.