Clinical
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Mitral Transcatheter Edge-to-Edge Repair Gains Traction in Cardiogenic Shock Patients
The authors of this large registry study examined transcatheter edge-to-edge repair in patients with cardiogenic shock and severe mitral regurgitation (MR). Successful repair was achievable in most patients and was associated with lower mortality rates and heart failure hospitalization at one year.
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Triglyceride-Lowering Therapy and Cardiovascular Events
Researchers studied pemafibrate vs. placebo in patients with type 2 diabetes, mild-to-moderate triglyceride elevations, and low levels of HDL and well-controlled LDL cholesterol. Despite a 31% reduction in triglyceride levels, there was no improvement in the risk of cardiovascular outcomes over a median follow-up of 3.4 years.
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Is It Better to Up-Titrate Medications Faster in Acute Heart Failure Patients?
Early intensive up-titration of guideline-recommended therapy in patients admitted for heart failure reduced 180-day readmission and all-cause mortality at the cost of more adverse events (but not serious or fatal ones).
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Is Screening for Atrial Fibrillation Cost Effective?
Self-screening for atrial fibrillation in elderly individuals could lead to lower stroke rates, prevent bleeding-related hospitalizations, and save money.
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New Therapy for Resistant Hypertension
Aprocitentan demonstrated efficacy for additional therapy beyond standard multidrug treatment in resistant hypertension.
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Can Artificial Intelligence Help Us to Choose the Best Anti-Seizure Medicine?
A new deep learning artificial intelligence algorithm was able to identify the most effective initial drug to treat newly diagnosed epilepsy, compared to the physicians’ clinical judgment. The algorithm required prospective, carefully collected clinical data for its success.
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Early Respiratory Decline in Amyotrophic Lateral Sclerosis
Hypercapnia, a manifestation of early respiratory dysfunction, can be challenging to detect in amyotrophic lateral sclerosis (ALS) patients. Pulmonary function tests are helpful, but their specificity in detecting hypercapnia is low and their use is limited in patients with bulbar weakness. Specific symptoms, such as dyspnea at rest, dyspnea while talking, and use of medications for sleep, can be more reliable in detecting hypercapnia among ALS patients.
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Atypical Presentations for Inclusion Body Myositis
Inclusion body myositis, the most common acquired myopathy, often is misdiagnosed or diagnosed after a delay of many years. Atypical presentations are not unusual, and clinicians should maintain a high degree of suspicion for this disorder when patients present with slowly progressive muscle weakness in an unusual pattern.
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Influence of Vitamin Intake on the Prevalence of Migraine
In a large population-based survey, 21.6% of participants reported having severe headaches or migraine. Those reporting severe headaches also reported a lower intake of thiamine and riboflavin, based on 24-hour recall of food intake. There also was an inverse relationship between thiamine intake and reports of severe headaches.
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Lipid Pathway Dysfunction in Parkinson’s Disease
In this large-scale study, the authors used a comprehensive untargeted lipidomic approach to determine the extent to which lipid dysregulation occurs in patients with Parkinson’s disease generally and in mutation carriers of one of the most common Parkinson’s disease risk genes, LRRK2. Further pathway analysis reveals sphingolipid metabolism, insulin signaling, and mitochondrial function as major metabolic pathways dysregulated in Parkinson’s disease.