Hematology/Oncology
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High-sensitivity Cardiac Troponin
In patients with new-onset chest pain without ECG evidence of an ST-elevation myocardial infarction, conversion to the use of a high-sensitivity troponin T assay with three-hour retesting in three hospitals was compared to maintaining the fourth-generation troponin T assay with six-hour retesting in three other hospitals. The use of high-sensitivity troponin T resulted in lower ED length of stay and costs, without increasing the use of coronary angiography or stress testing. -
Hyperoxia in ICU Patients May Cause Harm
Patients randomized to maintain oxygen saturation between 94-98% experienced better outcomes than patients allowed to receive partial pressure of oxygen > 150 mmHg. -
Hemoconcentration Associated with Lower Mortality in Acute Heart Failure
Among patients hospitalized for acute heart failure, hemoconcentration was associated with reduced 90-day mortality and may be a useful marker for guiding therapy. -
Do Antipsychotics Help with Delirium?
In palliative care patients suffering from delirium, managing delirium precipitants and individualized supportive strategies alone work better than adding risperidone or haloperidol. -
Vancomycin Combined with Piperacillin-Tazobactam Increases the Risk for Acute Kidney Injury
A retrospective cohort study found an increased risk of acute kidney injury for patients who received vancomycin in combination with piperacillin-tazobactam compared to those who received vancomycin plus cefepime (hazard ratio = 4.27; 95% confidence interval, 2.73-6.68). -
Troponin Highly Prognostic in Decompensated Heart Failure with Preserved Ejection Fraction
SYNOPSIS: Among patients with acute decompensated heart failure and preserved ejection fraction, elevated troponin is associated with worse in-hospital outcomes and long-term survival, independent of other predictors.
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NOACs in Patients Requiring Anticoagulation Post-PCI
SYNOPSIS: The PIONEER study of atrial fibrillation patients post-percutaneous coronary intervention showed that regimens of clopidogrel plus reduced-dose regimens of rivaroxaban demonstrated lower bleeding and similar rates of stroke and adverse cardiac events compared with traditional warfarin triple therapy.
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A New Risk Score for Stroke in Atrial Fibrillation
SYNOPSIS: A new, simpler score for stroke risk prediction in atrial fibrillation patients uses biomarkers to supplant many clinical variables and outperforms the CHA2DS2-VASc score in two large cohorts.
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Antibiotic Treatment in Community-acquired Pneumonia
SYNOPSIS: In patients with newly diagnosed community-acquired pneumonia, basing the duration of antibiotic treatment on clinical stability criteria led to a significant reduction in duration of antibiotic treatment without an increased risk of adverse outcomes.
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Discharge Antibiotic Prescriptions Often Are Inappropriate with Regard to Choice, Dose, Duration
SYNOPSIS: Seventy percent of discharge antibiotic prescriptions are inappropriate.