Hospital Medicine Alert
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Ticagrelor vs. Aspirin: Post-TIA and Stroke
The first 90 days after a transient ischemic attack or ischemic stroke is a high-risk period for recurrence of cardiovascular thrombotic events. Even with aspirin treatment, recurrences occur in as many as 10-15% of patients. -
Heart Failure with Recovered Ejection Fraction: A Distinct Phenotype
SYNOPSIS: Patients suffering from systolic heart failure who subsequently improve their ejection fraction experience a more favorable clinical course compared to those presenting with persistently reduced ejection fraction or heart failure with preserved ejection fraction.
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Noninvasive Ventilation Delivered Via Helmet May Decrease Intubation Rates
SYNOPSIS: In this single-center, randomized, clinical trial, among patients suffering from acute respiratory distress syndrome, the use of helmet noninvasive ventilation was associated with a reduction in intubation rates, ICU length of stay, and hospital and 90-day mortality.
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Influence of Sacubitril/Valsartan on 30-day Readmission After Heart Failure
SYNOPSIS: Compared with enalapril, treatment with sacubitril/valsartan is more effective in reducing 30-day readmissions for any cause following discharge from congestive heart failure hospitalization.
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Growing Threat of Pyelonephritis Caused by Antibiotic-resistant Escherichia coli
SYNOPSIS: In patients with acute pyelonephritis due Escherichia coli presenting to one of 10 emergency departments, the prevalence of fluoroquinolone resistance ranged from 6.3% to 19.9%, and the prevalence of extended-spectrum beta-lactamase production was 2.6% to 12.2%. Of those patients with resistant organisms, more than 50% received inactive empiric antibiotics.
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Safely Centralized Telemetry Off-site in a Multi-hospital System
SYNOPSIS: The hospitals in this study outsourced their cardiac telemetry to an off-site central monitoring center without an increase in adverse events.
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Triage to a Certified Stroke Center Reduces Early Mortality
In a national attempt to improve stroke care, there has been widespread certification of primary stroke centers (PSCs) by The Joint Commission. It has been assumed that outcomes will be better in the PSCs, but there have always been questions regarding how much additional time is acceptable to travel to a PSC, compared to a local hospital, in terms of successful treatment and outcomes.
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Chocolate Counteracts the Effects of Sleep Deprivation
SYNOPSIS: An acute administration of a chocolate rich in flavanols (a subclass of flavonoids) was found to mitigate the cardiovascular and cognitive effects of sleep deprivation in a group of young and healthy individuals.
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The Use of Dexmedetomidine for Sedation May Lead to Earlier Extubation and Decreased Ventilator Adverse Events
SYNOPSIS: The choice of dexmedetomidine or propofol over midazolam may improve outcomes in patients mechanically ventilated for three or more days.
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Screening for Coronary Artery Disease Is Underused in Heart Failure
Coronary artery disease is the most common cause of heart failure. Current practice guidelines recommend screening for Coronary artery disease in patients with newly diagnosed heart failure. However, few studies have evaluated how often clinicians perform diagnostic testing for Coronary artery disease on patients hospitalized with newly diagnosed heart failure.