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Dyspepsia represents a common yet nebulous symptom complex encountered in the daily clinical practice of primary care physicians, and it is frequently used synonymously with many different sets of symptoms marked by the presence of upper abdominal pain or discomfort.
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Deep sedation during the early period of mechanical ventilatory support delays extubation and increases mortality, yet is a modifiable risk factor that requires innovative intervention to reduce these adverse outcomes.
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Using a national database, the authors found that morbidly obese patients undergoing invasive mechanical ventilation had a similar risk of in-hospital mortality compared to non-obese individuals, despite having higher rates of invasive mechanical ventilation and tracheostomy.
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Nationwide from 2000-2009, there was a steady increase in the use of noninvasive ventilation (NIV) in managing acute respiratory failure, although the percentage of potentially eligible patients who receive it remains small. Importantly, the proportional increase was less for chronic obstructive pulmonary disease ([COPD] in which the evidence is compelling and NIV is the standard of care) than for non-COPD causes of respiratory failure (in which the evidence is weaker or conflicting).
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Most physicians who travel will encounter one or more emergencies during air travel. This paper reviews the experience of a medical communication center that serves five domestic and international airlines over a 34-month period.
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Statin therapy has multiple beneficial effects on coronary plaque, including prevention of plaque progression and reduction in thrombotic events. It is not clear if the beneficial effect on clinical events is due to reduction in lipid content of plaque.
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N-3 polyunsaturated fatty acids (n-3 FA) from fish have been reputed to prevent the development of cardiovascular disease (CVD) and have demonstrated some benefits in secondary prevention studies. Thus, this community-based investigator group in Italy conducted a double-blind, placebo-controlled trial of subjects with multiple risk factors for CVD (at least four, or one if diabetic) or evidence of atherosclerotic vascular disease, but without myocardial infarction (MI).
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Many laboratories have changed their practice to perform some procedures without stopping warfarin anticoagulation, but trial evidence supporting this practice has been lacking. In this paper, investigators from 17 centers in Canada and one in Brazil report the results of a trial comparing continued warfarin with heparin bridging in high-risk patients undergoing device procedures.