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Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia and has been the leading arrhythmic cause for hospitalization. With an increasing trend toward outpatient care of subacute illness, it is possible that the AF hospitalization rate is stable or decreasing despite the aging population.
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This study demonstrated an association between increased discontinuity of physician care in the inpatient setting and increased hospital costs at a tertiary care center.
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Ischemic stroke remains a leading cause of death worldwide, and atrial fibrillation is a major risk factor, increasing the risk of ischemic stroke five-fold in those who have a confirmed diagnosis of atrial fibrillation.
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HIV-infected patients diagnosed with cryptococcal meningitis who received antiretroviral therapy (ART) 5 weeks after starting antifungal therapy had improved survival at 26 weeks compared to similar patients who received ART at 1-2 weeks (45% vs 30%, respectively, P=0.03).
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The risk of recurrent venous thromboembolism (VTE) during extended anticoagulant therapy for thrombophilia remains poorly defined. Investigators analyzed 661 patients with idiopathic VTE who had been randomized to extended prophylaxis after three months of initial anticoagulation using either low-intensity (INR 1.5-1.9) or standard-intensity (INR 2.0-3.0) anticoagulation. Thrombophilic defects were identified in 42% of patients. The rate of recurrent VTE of only 0.9% per patient year was not influenced by thrombophilic abnormalities. Antiphospholipid antibodies trended toward increased recurrence (HR, 2.9; 95% CI: 0.9-10.5). The presence of thrombophilic defects did not increase the risk of recurrent VTE during extended anticoagulation relative to patients with idiopathic VTE without thrombophilic defects.
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Khan et al report a multicenter trial comparing pulmonary vein isolation vs AV junctional ablation with biventricular pacing in patients with atrial fibrillation and heart failure.
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A quality improvement intervention aimed at improving palliative care in the ICU resulted in improvements of nurse-assessed quality of dying and a reduction in ICU length of stay, but no changes in family perceptions of quality of dying or satisfaction with care.
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Through a retrospective analysis, this study examined ICU resource use and costs for 121,747,260 inpatient hospitalizations, and found a rapid rise in Medicare ICU use with stable adjusted daily critical care costs, but increasing costs for care outside the ICU.
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This single-center, randomized controlled trial demonstrated that intensive insulin therapy targeting blood glucose values of 80-110 mg/dL does not improve mortality, but does increase the incidence of hypoglycemia in a group of critically ill medical and surgical patients.
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Many clinical trials have confirmed the benefit of early invasive therapy for high-risk patients presenting with acute coronary syndromes (ACS). However, the optimal timing of cardiac catheterization in this group remains unknown.
