Primary Care/Hospitalist
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High-sensitivity Cardiac Troponin
In patients with new-onset chest pain without ECG evidence of an ST-elevation myocardial infarction, conversion to the use of a high-sensitivity troponin T assay with three-hour retesting in three hospitals was compared to maintaining the fourth-generation troponin T assay with six-hour retesting in three other hospitals. The use of high-sensitivity troponin T resulted in lower ED length of stay and costs, without increasing the use of coronary angiography or stress testing. -
Hyperoxia in ICU Patients May Cause Harm
Patients randomized to maintain oxygen saturation between 94-98% experienced better outcomes than patients allowed to receive partial pressure of oxygen > 150 mmHg. -
Hemoconcentration Associated with Lower Mortality in Acute Heart Failure
Among patients hospitalized for acute heart failure, hemoconcentration was associated with reduced 90-day mortality and may be a useful marker for guiding therapy. -
Do Antipsychotics Help with Delirium?
In palliative care patients suffering from delirium, managing delirium precipitants and individualized supportive strategies alone work better than adding risperidone or haloperidol. -
Vancomycin Combined with Piperacillin-Tazobactam Increases the Risk for Acute Kidney Injury
A retrospective cohort study found an increased risk of acute kidney injury for patients who received vancomycin in combination with piperacillin-tazobactam compared to those who received vancomycin plus cefepime (hazard ratio = 4.27; 95% confidence interval, 2.73-6.68). -
Stroke Risk From Use of Cannabis, Tobacco, and Alcohol
No associations between cannabis use in young adulthood and strokes later in life were found in multivariable models. An almost doubled risk of ischemic stroke was observed in those with cannabis use > 50 times; this risk was attenuated when adjusted for tobacco usage. Smoking ≥ 20 cigarettes per day was clearly associated both with strokes before 45 years of age and with strokes throughout the follow-up.
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Intravenous Nutrient Therapies — Worth the Cost?
Intravenous nutrient therapies are gaining in popularity to help patients maintain overall wellness, enhance weight loss, boost immune function, increase athletic performance, cure hangovers, and treat particular conditions. However, the increase in the use of these therapies in both healthy individuals and those with health conditions has not translated into increased published research studies investigating efficacy and safety.
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High-dose Biotin Shows Promise for Arresting Progressive Multiple Sclerosis Disability
In this double-blind, placebo-controlled study, patients with primary or secondary progressive multiple sclerosis were randomized to receive 100 mg of pharmaceutical-grade biotin or placebo thrice daily for 12 months. The primary endpoint of an improvement in the Expanded Disability Status Scale or a decrease in timed 25-foot walk time was achieved in 12.6% of the biotin-treated patients compared to no one in the placebo group (P = 0.005).
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Do Facebook Friends Count — for Health and Longevity?
An observational examination of California Facebook users suggested this population has a lower mortality rate than non-Facebook users; the lowest mortality risk is for Facebook users who combine a moderate degree of online social interaction with high offline social activity.
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Clinical Briefs
In this section: soothing dementia with music; the gastrointestinal tract and cardiology; NSAIDs might pose cardiovascular risks.