Higher-Dose Citalopram and the FDA Warnings: Not Much to Worry About?
Psychiatry
Summary and Comment
Free
In a large study, no increased cardiac risks were associated with citalopram doses higher than 40 mg/day.
By Joel Yager, MD
May 20, 2013
Covering:
Zivin K et al., Am J Psychiatry 2013 May 3
General Medicine
Summary and Comment
In older adults, higher circulating -3 fatty acid levels were associated with lower cardiovascular-related mortality.
Identifying Hospitalized Patients with QT Prolongation
General Medicine
Summary and Comment
A QT alert system flags electrocardiograms of patients at elevated risk for death.
By Kirsten E. Fleischmann, MD, MPH
May 7, 2013
Covering:
Haugaa KH et al., Mayo Clin Proc 2013 Apr; 88:315
Mizusawa Y and Wilde AAM., Mayo Clin Proc 2013 Apr; 88:309
Chest Pain: What Happens After the Emergency Department?
Emergency Medicine
Summary and Comment
Free
Patients who follow up with cardiologists do best.
Higher Potassium Intake Lowers Blood Pressure and Is Associated with Less Risk for Stroke
General Medicine
Summary and Comment
A BP-lowering effect was noted in hypertensive people and those with high sodium intake.
Continuing Statins May Improve Early Outcomes in Severe Sepsis
Infectious Diseases
Summary and Comment
Free
In a double-blind, randomized, phase II study, 28-day mortality among prior statin users was significantly lower with continued atorvastatin therapy than with placebo.
By Neil M. Ampel, MD
April 17, 2013
Covering:
Kruger P et al., Am J Respir Crit Care Med 2013 Apr; 187:743
O'Kane CM et al., Am J Respir Crit Care Med 2013 Apr; 187:672
High-Potency Statins Associated with Acute Kidney Injury
General Medicine
Summary and Comment
Free
Risk is greatest during the first 4 months of treatment.
Ampicillin plus Ceftriaxone for Enterococcus faecalis Endocarditis
Infectious Diseases
Summary and Comment
In an observational multicenter study, outcomes were similar between ampicillin plus ceftriaxone and ampicillin plus gentamicin, but renal dysfunction was significantly more common with the latter.
By Neil M. Ampel, MD
April 10, 2013
Covering:
Fernández-Hidalgo N et al., Clin Infect Dis 2013 May 1; 56:1261
Munita JM et al., Clin Infect Dis 2013 May 1; 56:1269
No One Is Dead Until Cold and Dead
Emergency Medicine
Summary and Comment
In a large, nationwide study, therapeutic hypothermia was initiated in only 2% of patients with return of spontaneous circulation after in-hospital cardiac arrest.
Nicotine Reprograms Reward Responses
Psychiatry
Summary and Comment
Some answers to the question of why it is so hard to quit smoking.
By Steven Dubovsky, MD
April 8, 2013
Covering:
Rose EJ et al., Biol Psychiatry 2013 Feb 1; 73:280
Addy NA and Picciotto MR., Biol Psychiatry 2013 Feb 1; 73:205
Field Activation of the Cath Lab Improves Door-to-Balloon Time
Emergency Medicine
Summary and Comment
Prehospital activation saved more than 40 minutes compared to activation on arrival.
Older Survivors of In-Hospital Cardiac Arrest Have Better Prognoses Than Expected
Hospital Medicine
Summary and Comment
1- and 3-year survival rates were 59% and 44%, respectively.
Pretest Probability for PE: Structured Scoring System or Clinical Judgment?
Emergency Medicine
Summary and Comment
Your gut feeling is probably as accurate as a structured score like the Wells score for pulmonary embolism.
No CV Benefit from Vitamin and Antioxidant Supplements
General Medicine
Summary and Comment
Taking vitamins and antioxidants does not prevent major adverse cardiovascular events.
Olmesartan vs. Olmesartan plus a Calcium-Channel Blocker
General Medicine
Summary and Comment
In a randomized trial, researchers found no difference between these two regimens in cardiovascular outcomes.
By Allan S. Brett, MD
February 14, 2013
Covering:
Ogawa H et al., Am J Med 2012 Oct; 125:981
Kim-Mitsuyama S et al., Kidney Int 2013 Jan; 83:167
Increasing Doses of Citalopram, Escitalopram, and Amitriptyline are Associated with QT Interval Prolongation
General Medicine
Summary and Comment
These observational results support the FDA's warning about cardiac changes.
EEG for Cardiac Arrest Patients Treated with Hypothermia
Neurology
Summary and Comment
A grading system for continuous electroencephalography readings correlated with outcomes.
No Increased Risk for MI or Stroke from Atazanavir
DAD results suggest that the association between MI risk and PI exposure is not a classwide phenomenon.
By Keith Henry, MD
February 4, 2013
Covering:
d'Arminio Monforte A et al., AIDS 2013 Jan 28; 27:407
Pravastatin in Pregnancy? Stay Tuned.
Women's Health
Summary and Comment
A potential strategy for preventing preeclampsia
Should "Continue Statins" Be Added to the Pre-Op Checklist?
Hospital Medicine
Summary and Comment
A large retrospective study confirms that statin use is associated with lower risk for postoperative acute kidney injury.
By Grace C. Huang, MD
January 28, 2013
Covering:
Brunelli SM et al., Am J Med 2012 Dec; 125:1195
Rosner MH., Am J Med 2012 Dec; 125:1153
Clinically Significant Events During Transport of STEMI Patients
Emergency Medicine
Summary and Comment
In a single emergency medical services system in Toronto, clinically significant events occurred in 27% of patients directly transported to a percutaneous coronary intervention center.
Is Endocarditis a General Marker for Cancer?
Infectious Diseases
Summary and Comment
In a Danish population-based study, the overall risk for cancer was increased eightfold within 3 months of endocarditis diagnosis and remained elevated 5 years later.
By Neil M. Ampel, MD
January 23, 2013
Covering:
Thomsen RW et al., Am J Med 2013 Jan; 126:58
Adverse Cardiac Events Rare in Certain Chest Pain Patients
Emergency Medicine
Summary and Comment
The study suggests patients presenting with a normal ECG, TIMI score of zero, and negative highly sensitive troponin I assay may be safely discharged from the ED, but it needs validation.
Remarkable Cardiac Regeneration
General Medicine
Summary and Comment
Gene therapy with microRNAs caused cardiac muscle regeneration after myocardial infarction in mice.
By Anthony L. Komaroff, MD
January 17, 2013
Covering:
Eulalio A et al., Nature 2012 Dec 20/27; 492:376
Mercola M., Nature 2012 Dec 20/27; 492:360
Is Prehospital Advanced Airway Management Harmful for Cardiac Arrest Patients?
Emergency Medicine
Landmark Article
Free
Outcomes were better with bag-valve-mask ventilation than with advanced airway management.