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Timely recognition and treatment of myocardial infarction (MI) are crucial if we are to achieve optimal outcomes for our patients. Silent ischemia, or the absence of classical symptoms of ischemia, may delay the diagnosis.
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Although current guidelines recommend delaying neuroprognostication during therapeutic hypothermia following resuscitation from cardiac arrest, this review of 55 consecutive patients so managed found that a "poor prognosis" designation was arrived at during the hypothermia period in most of them, including six patients who were eventually discharged with a favorable neurologic outlook.
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Two large, well-known, U.S. prospective cohort studies, the Nurses' Health Study and the Health Professionals Follow-up Study, evaluated both sugar-sweetened and diet (low-calorie, also called artificially sweetened) soda consumption over 20 years and found one or more daily servings to be associated with a significantly higher risk of stroke.
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In this study of patients imaged with CT angiography, finding of the presence of diagonal earlobe creases was independently and significantly associated with increased prevalence, extent, and severity of coronary artery disease.
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Dangers of antibiotics are well known and recent research brings to light new dangers of commonly used medications. Five days of azithromycin results in 47 additional deaths from cardiovascular disease compared with amoxicillin and no antibiotic. One out of 2500 patients treated with a fluoroquinolone (ciprofloxacin, levofloxacin, and norfloxacin) suffer a retinal detachment. These antibiotics should be used only when there is a clear clinical need and with caution.
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Unless a dramatic demographic shift occurs, approximately one in four of us will reside in a long-term care facility (LTCF) during our lifetime. Among LTCF residents, 30-50% of antibiotic utilization is for urinary tract infections (UTIs), resulting in substantial expense, adverse drug reactions, and ever-growing populations of resistant bacteria.
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Treatment for headache, including the migraine headache, has significantly changed in the past decade. Causes for headaches, specifically of the migraine type, are still the subject of much debate. Headaches are currently divided simply as primary and secondary. Primary headaches are described as being "idiopathic," or not due to an actual disease process or external stimulus. Secondary headaches are classified as being due to an underlying disease/illness, such as sinusitis, or due to an external stressor, for example, trauma resulting in a closed head injury.
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