Internal Medicine
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Vasopressin Use in Septic Shock
Current management of septic shock includes early administration of intravenous fluids, antimicrobial agents, and vasopressor support. While norepinephrine is recommended as the first-line vasopressor for septic shock in the 2016 Surviving Sepsis Campaign guidelines, vasopressin is a second-line vasopressor option that may be added.
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A Review of Atrial Fibrillation and Current Therapeutic Strategies: Part 1
This two-part series presents a review of the current evidence on atrial fibrillation. The first part includes its definition, classification, risk factors, comorbidities, evaluation, and acute management of newly diagnosed patients. The second part will focus on long-term management, including risk factor modification, rate and rhythm control measures, stroke risk stratification, and anticoagulation management.
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Cardiac Arrest in Takotsubo Syndrome
Investigators sought to determine whether secondary prevention interventions could reduce the mortality rate of takotsubo patients with cardiac arrest.
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Safety of Carvedilol for Cocaine Users
The use of beta-blockers in cocaine users is controversial, and there are few data on their use in cocaine-associated heart failure. This prospective, observational, registry study of cocaine-associated heart failure patients showed that carvedilol is safe and effective in such patients.
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Planning Therapy for Severe Tricuspid Regurgitation
A retrospective study of moderate to severe secondary tricuspid valve regurgitation showed that right ventricular systolic dysfunction (but not dilatation alone) is predictive of all-cause mortality.
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Predicting Chemotherapy Cardiotoxicity
Administering trastuzumab after a course of anthracycline therapy for breast cancer can result in cardiac toxicity. Serial echocardiograms in this study showed that a lower initial left ventricular ejection fraction before anthracycline therapy and the amount of decrease in ejection fraction after the anthracycline course are predictive of subsequent trastuzumab cardiac toxicity.
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When and How to Stop Dual Antiplatelet Therapy After PCI
Among patients with high-risk percutaneous coronary intervention who had completed three months of dual antiplatelet therapy with ticagrelor, patients who were randomized to ticagrelor alone experienced similar ischemic outcomes and a lower risk of bleeding at one year compared with those maintained on ticagrelor and aspirin.
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Semaglutide Tablets (Rybelsus)
Semaglutide is indicated as adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus.
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After Ischemic Stroke Related to Atrial Fibrillation, Direct Oral Anticoagulants Are Superior to Vitamin K Antagonists
Researchers investigated the benefits and risks of early anticoagulation following acute ischemic stroke, and compared the effects of direct oral anticoagulants vs. vitamin K antagonists.
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Amyloid, Tau, Neurodegeneration Diagnostic Framework to Predict Memory Decline Before the Onset of Dementia
In a population-based longitudinal study of older individuals without dementia, the inclusion of imaging biomarkers for amyloid, tau, and neurodegeneration modestly improved the ability to predict memory decline compared to a model that only used clinical data and APOE genotype.