Clinical
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Is the Canadian Syncope Risk Score Valid?
Researchers found the Canadian Syncope Risk Score accurately predicts which patients are low risk for discharge. However, since it is driven largely by the physician’s final risk classification at ED discharge, the score’s clinical utility is uncertain.
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Comparing CT Angiography to Invasive Angiography for Stable Chest Pain Patients
A trial of initial coronary CT angiography vs. invasive angiography revealed outcomes over a median 3.5-year follow-up were similar, but procedure-related complications were more common in the invasive group.
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Outcomes of COVID-19-Associated Acute Myocarditis
In a review of COVID-19-associated acute myocarditis, investigators learned it is a rare complication that can occur without concomitant pneumonia, and frequently presents as cardiogenic shock. With supportive therapy, the short-term mortality rate is low.
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Baricitinib Tablets (Olumiant)
Baricitinib is the first FDA-approved systemic treatment of alopecia areata.
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What Do You Think Happened?
You are asked to interpret the tracing in the figure without the benefit of any history. What do you think happened? How acute are these findings?
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Researchers Suggest Checking Blood Pressure in Both Arms
After taking two readings, use the higher measurement for diagnosis. Guidelines recommend this practice, but data were lacking.
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COVID-19: Duration of Shedding of Transmissible Virus
Patients with COVID-19 were found, by culture, to shed replication-competent virus after an initial positive polymerase chain reaction test for median durations four to five days.
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Paxlovid Rebound Concerns Are Overblown
A cohort of 483 high-risk patients was treated with nirmatrelvir/ritonavir for COVID-19. Two of the patients (0.4%) required hospitalization by day 30, and four patients (0.8%) experienced a rebound of symptoms (generally mild) at median of nine days after treatment. All resolved without additional COVID-19-directed therapy.
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COVID-19 Rebound
Symptomatic and virologic recrudescence after treatment of patients with COVID-19 with nirmatrelvir/ritonavir (Paxlovid) — Paxlovid rebound — occurs in a very small percentage of patients and generally is mild and self-limited.
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12 Months of Itraconazole Is Superior to Six Months for Preventing Relapses of Chronic Pulmonary Aspergillosis
A randomized, controlled clinical trial from India found a significant reduction in relapses of chronic pulmonary aspergillosis in patients treated with itraconazole for 12 months compared to those treated for six months. There were more adverse events in the patients treated for 12 months.