Hospital Medicine Alert
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Percutaneous Coronary Interventions in Nonagenarians
Nonagenarians can undergo percutaneous coronary interventions with low in-lab complication rates, but 30-day and one-year mortality is considerably higher than in younger patients.
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Palliative Care-based Intervention Improves Quality of Life in Chronic Heart Failure
Among patients with advanced heart failure, implementation of an interdisciplinary palliative care intervention was associated with improved quality of life.
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Advance Care Planning Must Advance Forward
In a systematic review of 795,909 people in 150 studies, researchers found many Americans have not completed an advance directive.
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Safe Treatment Recommendations for Benzodiazepine Dependence
SYNOPSIS: There are clear, evidence-based treatment withdrawal regimens for benzodiazepine-dependent patients.
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Maternal Mortality, Postpartum Hemorrhage, and Tranexamic Acid: The WOMAN Study
SYNOPSIS: A multicenter study involving patients in 193 countries has shown a decrease in maternal mortality in women with postpartum hemorrhage who were given tranexamic acid once the diagnosis was made.
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Requiem for Beta-blockers Post-Myocardial Infarction?
SYNOPSIS: A propensity score analysis of all hospital survivors of acute myocardial infarction in the United Kingdom from 2007-2013 showed that one-year survival in hospital patients without heart failure or left ventricular dysfunction treated with beta-blockers did not differ from survival in those patients not so treated.
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Early Diuretic Administration Associated With Improved Survival in Acute Heart Failure Patients
SYNOPSIS: Among patients presenting to the ED with acute heart failure, those who received the first dose of intravenous furosemide within 60 minutes of arrival demonstrated lower in-hospital mortality compared to those receiving the first dose after 60 minutes.
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Cefazolin Leads to Better Outcomes for Methicillin-susceptible Staphylococcus aureus Bacteremia Than Nafcillin or Oxacillin
SYNOPSIS: A retrospective study that included patients from 119 Veterans Affairs hospitals found lower mortality and a similar recurrence rate for methicillin-susceptible Staphylococcus aureus bacteremia treated with cefazolin compared to nafcillin and oxacillin.
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Distinguishing Ischemic from Non-ischemic Cardiomyopathy Clinically
SYNOPSIS: This cardiac catheterization-based study of patients with newly diagnosed reduced left ventricular ejection fraction of unknown etiology showed that 15% had ischemic cardiomyopathy and they could be identified by clinical characteristics and an ECG-based risk score.
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B-type Natriuretic Peptide Is Less Useful in Elderly Patients with Dyspnea
SYNOPSIS: Among patients ≥ 80 years of age presenting with acute dyspnea, B-type natriuretic peptide level was not useful for differentiating cardiac vs. respiratory etiologies when added to a model of clinical predictors.