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Time to primary PCI is strongly associated with mortality risk and is important regardless of time from symptom onset to presentation and regardless of baseline risk of mortality.
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Pregnancy is a prothrombotic state which is rarely associated with ischemic arterial stroke. However, when a stroke occurs, especially in later pregnancy, the options for therapy may be limited.
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Overall, clopidogrel plus aspirin was not significantly more effective than aspirin alone in reducing the rate of myocardial infarction, stroke, or death from cardiovascular disease.
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Antibody testing successfully identified 7 patients whose encephalitis was due to the free-living amoeba, Balamuthia mandrillaris, a pathogen that should be suspected in individuals with soil contact, high CSF protein, and mass-like or ring-enhancing brain lesions.
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Acute Q fever may progress to endocarditis in patients with clinically silent valvulopathy. Those at risk require either extended antibiotic prophylaxis or close serological follow-up. All patients with acute Q fever should undergo transthoracic echocardiography, or in some instances transesophageal echocardiography, to exclude occult valvular abnormalities.
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All of the currently available non-invasive techniques for carotid artery imaging give accurate results when there is a high-grade stenosis (70-99%), but contrast-enhanced MRA is slightly more sensitive.
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In this retrospective case-control study, carotid stenting with cerebral protection and carotid endarterectomy were not significantly different in early morbidity and mortality.
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Seventeen cases of community acquired pneumonia due to Staphylococcus aureus are described. Most were methicillin resistant and caused severe disease with high mortality.
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This study in patients presenting to the emergency department with acute dyspnea showed that rapid BNP testing is cost-effective during the initial hospital encounter as well as at 180 days.
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Fatigue occurs commonly in patients with cancer, particularly when receiving chemotherapy or radiation. Furthermore, in long term survivors, persistent fatigue occurs in up to one third. Although anemia is one contributing factor, fatigue certainly occurs in its absence as well. Two recent reports are reviewed; one addressing the mechanisms and biochemical markers of persistent fatigue, and the other introducing a novel therapeutic approach directed at chemotherapy-associated fatigue. It is quite apparent that dysregulation of inflammatory mechanisms accounts for some component of fatigue and anti-inflammatory treatments may be of great value.
