Internal Medicine
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Neuromuscular Blockade and Successful Endotracheal Intubation
Previous studies have shown the utility of neuromuscular blocking agents for endotracheal intubation in the operating room and emergency department. However, airway management in the ICU often involves unplanned, emergent intubations under suboptimal conditions. This study asked whether NMBAs improved first attempt success of intubations in the ICU. Additionally, these authors asked whether succinylcholine or rocuronium improved first attempt success and the effects of NMBA on intubations using video laryngoscopy.
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Does Functional Ability Prior to an ICU Admission Influence Outcomes in Older Adults?
The impact of an older person’s functional status prior to experiencing hospitalization for a critical illness is difficult to determine. Given that ICU admission is generally an unplanned event, obtaining prospective evaluations of function prior to a critical illness or injury is almost impossible. Most evidence to date has utilized proxy reports for a patient’s functional status to determine what, if any, pre-ICU disability may have on an older adult’s outcomes after hospitalization for a critical illness or injury.
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Assessment, Prevention, and Treatment of Delirium in the ICU
A review of the latest Society of Critical Care Medicine clinical practice guidelines.
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Neurologic Disease and Criminal Behavior – A Medicolegal Conundrum
Patients with frontotemporal dementia, primary progressive aphasia, and Huntington’s disease exhibited antisocial and/or criminal behavior.
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Urinary Tract Infection
MONOGRAPH: More than 8 million medical visits per year are for the chief complaint of UTI and the diagnosis accounts for 100,000 admissions annually.
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Clinical Briefs
Clinical Briefs on topics such as: Chronobiology and Insulin Glargine, Dual Add-on Therapy for Type 2 Diabetes When Metformin is Not Enough, and Might Long-term Dual Antiplatelet Therapy Be Better? Not
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Are Atrial Premature Complexes Benign?
Atrial premature complexes (APCs) are commonly observed on routine ECGs and believed to be harbingers of atrial fibrillation, especially in patients with cardiovascular disease. However, little is known about the long-term prognosis of APCs in the general population. Thus, these investigators from Japan analyzed the database of a large community-based cohort from 1993 to 2008 to determine the risks of APCs seen on the subjects’ baseline ECGs.
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Statins After an MI: Does it Happen?
Following a hospitalization for coronary heart disease (CHD) or acute coronary syndrome (ACS), randomized trials demonstrate that high-intensity atorvastatin is more effective than either placebo or low- to moderate-intensity therapy with either pravastatin or atorvastatin.1-3 Based on this evidence, the American College of Cardiology and the American Heart Association guidelines recommend high-intensity therapy in cases of an acute cardiac event and that therapy be initiated before discharge.
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Is it Worth it? Do “Healthy” Dietary Guidelines Lower the Risk of Heart Disease?
Recent controversy surrounds diet and its impact on cardiovascular disease (CVD). In this study, Reidlinger and her colleagues sought to assess diet by comparing the effects on vascular and lipid CVD risk factors of adhering to a diet consistent with United Kingdom (UK) dietary guidelines (DG group) to a traditional British diet (control group).
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Another Reason to Recommend Smoking Cessation
Atrial fibrillation (AF) is the most common arrhythmia encountered in clinical practice, affecting an estimated 2.7 million individuals in the United States.1 The proportion of strokes attributable to AF increases strikingly from 1.5% at 50-59 years of age to 23.5% at 80-89 years of age.2 Approximately 15-20% of all strokes are due to AF. To predict the thromboembolic risk in the individual patient, risk models used most frequently are CHA2DS2-VASc and CHADS2 scores. The CHA2DS2-VASc score may be the better option since both the 2014 American Heart Association, American College of Cardiology, Heart Rhythm Society AF guidelines, and the 2012 European Society of Cardiology AF guidelines prefer it when evaluating the individual thromboembolic risk associated with AF and to determine the risk:benefit ratio of antithrombotic therapy.3