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In an epidemiologic analysis of SEER data, middle-aged patients with early-stage disease who opted for active surveillance rather than retroperitoneal lymph node dissection experienced a greater rate of second malignancy. The investigators speculate that this may relate to increased radiation exposure (multiple CT scans) and a greater likelihood of subsequent chemotherapy use.
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In a randomized, double-blind, placebo-controlled trial, clonidine and venlafaxine both proved superior to placebo in reducing hot flashes in breast cancer patients. The study was insufficiently powered to prove superiority of one drug over the other. However, venlafaxine produced earlier reductions and it appeared clonidine had more sustained effect (i.e., at 12 weeks of treatment).
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Admission to an ICU increased risk for unintentional medication discontinuation in four of five medication groups commonly used to manage a chronic illness.
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Patients who have had percutaneous coronary intervention (PCI) with either bare metal stents (BMS) or drug-eluting stents (DES) require dual antiplatelet therapy until the stent struts are endothelialized. However, patients who have had prior PCI often need to undergo surgery.
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In this study from a single medical ICU, prompting physicians to discuss all six items on a daily rounding checklist, as compared with the use of the same checklist without prompting, significantly improved several processes of care and appeared to decrease length of stay and mortality as well.
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In severe symptomatic aortic stenosis (AS), surgical AVR improves mortality, but there is no medical therapy proven to slow progression of the valvular stenosis. Because AS is accompanied by left ventricular (LV) hypertrophy and fibrosis, and because the risk factors for AS are similar to those for coronary artery disease (CAD), it makes sense that blockade of the renin-angiotensin system may benefit patients with AS.
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Saddle pulmonary embolism was found in 37 of 680 patients with documented pulmonary embolism (PE) in this community hospital study. The great majority of these patients did well on standard therapy without thrombolytics, emphasizing that the radiographic finding of saddle PE should not by itself be equated with the much more serious clinical entity of massive PE.
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Since there is a lack of prospective data on the frequency of which constrictive pericarditis (CP) develops after acute pericarditis (AP), this group of investigators from Torino, Italy, conducted such a study.