Clinical
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Medical Treatment of Acute Appendicitis in Children
A meta-analysis demonstrated a 90.5% success rate of medical treatment compared to appendectomy for acute uncomplicated appendicitis in children 5-15 years of age. There was a nearly nine-fold higher risk of failure with antibiotic treatment, indicating that appendectomy remains the standard of care.
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Study Challenges Orthodoxy of IV Hydration for Prevention of Contrast Nephropathy
SYNOPSIS: This trial randomized 660 patients with chronic kidney disease and a planned procedure requiring intravascular iodinated contrast to prophylactic hydration or to no hydration. No hydration was found to be non-inferior for prevention of contrast-induced nephropathy and saved significant costs.
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Clindamycin Improves Outcomes in Necrotizing Fasciitis due to Group A Streptococcus
SYNOPSIS: Using a murine model of necrotizing fasciitis, investigators determined that clindamycin inhibits key virulence factors of Group A Streptococcus, and should be given as soon as possible and at high doses to reach levels above MIC in affected tissues.
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Surviving Sepsis Campaign Guidelines Bundle: Studying How Improved Compliance Might Affect Outcomes
SYNOPSIS: Improved compliance with the Surviving Sepsis Campaign guidelines bundle was associated with a non-statistically significant decrease in the in-hospital mortality of severe sepsis patients.
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The ABCs of In-hospital Cardiac Arrest
SYNOPSIS: In this large, propensity-matched cohort study of patients who experienced an in-hospital cardiac arrest, patients who underwent endotracheal intubation had worse survival to hospital discharge than patients who were not intubated.
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Tolvaptan Fails to Improve Dyspnea in Acute Heart Failure
In patients hospitalized for acute heart failure, adding tolvaptan to furosemide lead to increased weight and fluid loss, but did not improve dyspnea at 24 hours.
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Can Echo/Doppler Accurately Estimate LVEDP in Pulmonary Hypertension Patients?
In patients with pulmonary hypertension evaluated in a specialty clinic, echo/Doppler estimation of left ventricular end-diastolic pressure is not reliable for the determination of pre- vs. post-capillary pulmonary hypertension.
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Cardiac Resynchronization Therapy Reduces New Onset Ventricular Arrhythmias
In an analysis of the landmark Resynchronization in Ambulatory Heart Failure Trial, patients without prior ventricular arrhythmias randomized to cardiac resynchronization therapy experienced significantly less new onset ventricular arrhythmias than those randomized to implantable cardioverter defibrillator alone.
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Predicting Electrical Cardioversion Failure
A study of the 30-day success rate of electrical cardioversion of acute atrial fibrillation revealed five clinical predictors of recurrence.
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Complete vs. Infarct-related, Artery-only Revascularization in STEMI
Researchers randomized patients with ST elevation myocardial infarction and at least one noninfarct artery with angiographically significant stenosis to either fractional flow-reserve-guided complete revascularization by percutaneous coronary intervention or to no revascularization of noninfarct arteries.