Internal Medicine
RSSArticles
-
Lyme Disease in the United States — Good News, Bad News
The incidence of Lyme disease appears to have stabilized in states with known high incidences of the infection, but there is evidence of geographic expansion into neighboring states.
-
Mumps Vaccine — Third Dose During Outbreaks
Mumps immunity wanes over time, with a notable increase in risk of infection 13 or more years after completion of the currently recommended series of vaccines. During an outbreak of mumps, receipt of an extra (third, by American schedules) vaccine significantly reduces the risk of becoming sick with mumps.
-
Optimizing Outcomes for Invasive Treatment of Long-standing, Persistent Atrial Fibrillation
In patients with long-standing, persistent atrial fibrillation, outcomes with an electrophysiologically guided thoracoscopic surgical ablation procedure were superior to a standard catheter approach.
-
Cardiac Magnetic Resonance Identifies High-risk Patients With Acute Myocarditis and Preserved Ejection Fraction
In patients with acute myocarditis and preserved left ventricular ejection fraction who underwent cardiac magnetic resonance, the presence of late gadolinium enhancement involving the midwall layer of the anteroseptum was associated with a worse prognosis.
-
Value of Liver Function Tests in Cardiogenic Shock
A prospective, multicentered, observational study of patients admitted with cardiogenic shock showed that a > 20% rise in alanine aminotransferase in the first 24 hours is associated highly and independently with 90-day mortality.
-
Risk of Major Bleeding With Concurrent Medications in Atrial Fibrillation Patients Taking New Oral Anticoagulants
A large nationwide comprehensive clinical database showed that concomitant use of the new oral anticoagulants with amiodarone, fluconazole, rifampin, and phenytoin increases the risk of major bleeding.
-
ORBITA: Learning the Right Lessons From a Sham-controlled Trial of Angioplasty
In this sham-controlled trial of 200 patients with single-vessel coronary artery disease and stable angina, percutaneous coronary intervention did not increase exercise time significantly compared to a placebo procedure.
-
Oncologists and Intensivists Perceive Prognosis Differently for Critically Ill Patients With Cancer
When considering prognostication or limitation of care in critically ill patients with different cancers, oncologists may focus on cancer characteristics, whereas intensivists may focus on multiple organ failure.
-
Deflating Recruitment Maneuvers
Compared to the ARDSNet lower positive end-expiratory pressure (PEEP)/low tidal volume strategy, use of an “open lung ventilation” strategy consisting of aggressive alveolar recruitment maneuvers and higher PEEP is associated with higher mortality in patients with moderate to severe acute respiratory distress syndrome.
-
Right Heart Failure in the ICU
Right ventricular (RV) failure continues to be a formidable clinical challenge in critical care medicine. Regardless of the etiology, pulmonary hypertension and RV failure carries a poor prognosis. Prompt identification and treatment is warranted. Unfortunately, there is considerable lack of evidence in the management of RV failure in the medical ICU. Most recommendations are based on expert opinion or low-quality evidence.