Debate over the cardiovascular effects of COX-2 inhibitors has raged for more than a year since a special communication was published in JAMA last August suggesting an increase in cardiovascular events with rofecoxib (Vioxx). Now a large retrospect, the cohort study from the Tennessee Medicaid program seems to confirm the prothrombotic effects of rofecoxib, at least in high dose.
While stroke is most often a result of progressive atherosclerotic cerebrovascular disease, occurring with increasing frequency as the population ages, there are less common causes of stroke that mainly affect younger populations.
A randomized controlled trial in Australia showed that a 16 week program of tai chi reduced falls by 33% in a group of elderly persons.
Two hundred eighty-eight patients hospitalized with severe community-acquired pneumonia (CAP) were followed for 28 days in a prospective multicenter study. At day 7, 25% of patients had resolution of CXR abnormalities and 56% had improvement. At day 28, 53% of patients had resolution of CXR abnormalities and 78% had clinical cure. By multivariate analysis, delayed resolution of CXR abnormalities by day 7 was associated with multilobar disease, dullness to percussion by physical exam, elevated CRP (> 200 mg/L), and tachypnea (respiratory rate > 25/min.) on admission.
Asymptomatic brain MRI findings of infarct, cerebral aneurysms and benign tumors were fairly common in the general population. The clinical significance of these findings is unknown.