Internal Medicine
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Antibiotics for Acute Appendicitis
Appendectomy has been the treatment for acute appendicitis since the late nineteenth century. During the past decade, the notion of treating acute appendicitis with antibiotics alone has been proposed and evaluated in several clinical trials. However, these trials have been criticized because of methodological limitations.
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Is Peripheral Intravenous Administration of Vasopressors Really Safe?
Vasoactive medications are most commonly administered through central venous catheters -
Emergent Vascular Access: Is Intraosseous Better Than Central Venous Catheter Placement?
Traditionally, the easiest vascular access has been placement of a triple lumen catheter in the femoral vein, as anatomic landmarks here are often easier to identify than other areas, minimizing the need for ultrasound assistance. -
Rate and Predictors of Futile Hospital Transfers for Acute Stroke Endovascular Therapy
A large number of futile transfers take place for consideration of endovascular therapy, and better selection criteria need to be developed.
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Circadian Rhythms Predict Small Vessel Ischemic Disease
The presence of white matter infarcts and cerebral microbleeds is associated with disruption of sleep but not total sleep time.
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Pattern of Atrial Fibrillation Is Associated with Outcomes After Stroke
In a Japanese stroke registry, permanent as opposed to paroxysmal atrial fibrillation was associated with higher in-hospital mortality after stroke.
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Blood Pressure Lowering After Acute Stroke: Can It Kill You?
Patients with chronically elevated blood pressure are at increased risk of all-cause and cardiovascular death, with a particularly increased risk of ischemic and hemorrhagic stroke. Treatment to lower systolic BP decreases stroke risk, without an apparent lower threshold down to 120 mmHg. However, lowered SBP (≤ 120 mmHg) in the 5 years after a stroke may be associated with increased mortality. Lower SBP over a shorter period of time after a stroke in chronically hypertensive patients could potentially increase mortality as well.
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Incidental Cerebral Microbleeds and Cerebral Blood Flow in Elderly Individuals
Cerebral microbleeds in non-demented elderly people are associated with a global reduction in cerebral blood flow and a high prevalence of beta-amyloid deposition in the brain.
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Idarucizumab: A Promising New Drug that Reverses the Anticoagulant Effects of Dabigatran
A recent study found that idarucizumab rapidly reverses the effects of dabigatran and is likely to have important clinical benefits for patients with intracerebral hemorrhage and other disease processes in which reversal of anticoagulation is important.
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Diverticulitis: Evaluation and Management
Diverticulitis is a result of acute inflammation of colonic diverticulum. Acute diverticulitis is placing an increasing burden on health care resources as the incidence, prevalence, and hospital admission rate is rapidly increasing. Its timely diagnosis and treatment are essential to help improve outcomes for patients. The ability to recognize complicated versus uncomplicated diverticulitis can aid in expedited care and resource allocation to prevent repeat radiation exposure through radiological imaging of these patients who present with uncomplicated diverticulitis.