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Chest pain presentations to the emergency department (ED) are common and very costly to the health care system. Although the event rates are low in patients with a low clinical risk profile, the price of a missed diagnosis is high.
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In this paper, the authors reviewed long-term survival data from a large population of out-of-hospital cardiac arrest patients who were discharged alive after their arrest. All patients who have a cardiac arrest in Seattle and King County, Washington, are entered into a registry organized to follow the Utstein guidelines for reporting cardiac arrest.
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In this randomized study, patients with left-sided infective endocarditis and large vegetations who underwent valve replacement surgery within 48 hours of randomization had lower rates of embolic events and death from any cause after 6 months compared to those who underwent surgery later.
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Some patients who experience stroke or transient ischemic attack (TIA) of unknown cause (i.e., cryptogenic) are subsequently found to have a patent foramen ovale (PFO).
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When fewer ICU beds were available, patients experiencing a medical emergency team call were less likely to be admitted to the ICU and more likely to have their goals of care changed.
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A significant risk factor for ICU readmission is the illness severity (acute physiology score) associated with persistent physiological abnormalities at ICU discharge, regardless of initial ICU admission illness severity.
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Early cessation of prehospital seizures via an intramuscular injection of midazolam was at least noninferior, if not superior, to traditional intravenous lorazepam.
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Patients presenting to the emergency department (ED) with chest pain are often admitted to "rule out" myocardial infarction (MI). Many of the patients are subsequently found to have noncardiac causes of chest pain.
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The risk of interrupting prophylactic warfarin for stroke prevention in atrial fibrillation (AF) patients is unclear. Thus, these investigators from Denmark evaluated their national health registry and found 102,591 patients > age 30 with a first-time hospitalization for AF between 1997 and 2008.
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Based on their review of prior published studies of telemedicine ICUs and the initiation of a telemedicine ICU in a Veterans Health Administration hospital system, the authors find that costs of implementation are substantial and the sum impact on hospital expenses and profits remains unclear.