Clot Risk Remains High in Medical Patients After Discharge
Hospital Medicine Summary and Comment
A study of medically ill hospitalized patients revealed that more than half of venous thromboembolic events occurred after hospital discharge.
Post-Arrest Troponin I Level Is a Poor Predictor of Recent Occlusion
Emergency Medicine Summary and Comment
Troponin I level at admission cannot be used to predict which patients need immediate cardiac catheterization.
Infective Endocarditis Involving Implantable Cardiac Devices
Infectious Diseases Summary and Comment
Free
Both in-hospital and 1-year mortality rates were high in this multinational survey.
Pregnancy Complications as an Omen for Cardiovascular Disease
Women's Health Summary and Comment
Free
Women who delivered small-for-gestational-age babies were more likely to experience ischemic heart disease in later life.
Electrical Cardioversion of Atrial Fibrillation Is Safe and Effective in the ED
Emergency Medicine Summary and Comment
Free
Electrical cardioversion was more effective than pharmacological cardioversion with propafenone.
Preventing Upper Gastrointestinal Bleeding in Patients with Acute Coronary Syndrome
Gastroenterology Summary and Comment
A proton-pump inhibitor was superior to an H2 -receptor antagonist.
Why Health Literacy Matters
General Medicine Summary and Comment
Low health literacy was associated with higher all-cause mortality.
Dispatcher-Directed Cardiopulmonary Resuscitation Improves Survival in Pediatric Out-of-Hospital Cardiac Arrest
Emergency Medicine Summary and Comment
In a population-based Japanese study, dispatcher assistance increased 1-month survival but had no effect on neurological outcomes.
World Heart Federation Guidelines for the Echocardiographic Diagnosis of Rheumatic Heart Disease
Infectious Diseases Clinical Practice Guideline Watch
These guidelines establish minimum echocardiographic criteria for diagnosing RHD and should enable identification of this condition in individuals with no history of acute rheumatic fever.
Between-Arm Systolic Blood Pressure Differences and Adverse Outcomes
General Medicine Summary and Comment
In a prospective cohort study, differences in systolic blood pressure were associated with excess risk for cardiovascular events and death.
Rheumatoid Arthritis Linked to Risks for Atrial Fibrillation and Stroke
General Medicine Summary and Comment
Free
Close monitoring of RA patients is warranted.
Therapeutic Hypothermia for Cardiac Arrest in the Prehospital Setting
Emergency Medicine Summary and Comment
Prehospital initiation of cooling for patients with nonventricular fibrillation cardiac arrest did not improve outcomes compared with in-hospital cooling.
By Kristi L. Koenig, MD, FACEP
March 9, 2012
Covering:
Bernard SA et al., Crit Care Med 2012 Mar; 40:747
Behringer W and Arrich J., Crit Care Med 2012 Mar; 40:984
Patient Satisfaction Associated with Higher Healthcare Costs
General Medicine Summary and Comment
Satisfaction may be related to patients requesting and receiving unnecessary tests and treatments.
By Thomas L. Schwenk, MD
March 6, 2012
Covering:
Fenton JJ et al., Arch Intern Med 2012 Feb 13
Sirovich BE., Arch Intern Med 2012 Feb 13
Septic Shock? Reach for Norepinephrine After Fluid Resuscitation
Emergency Medicine Summary and Comment
Free
A meta-analysis shows that dopamine is associated with increased risk for death and arrhythmic events compared with norepinephrine.
By Kristi L. Koenig, MD, FACEP
March 2, 2012
Covering:
De Backer D et al., Crit Care Med 2012 Mar; 40:725
Annane D., Crit Care Med 2012 Mar; 40:981
A Pharmacist-Led Intervention Reduces Medication Errors in Primary Care
General Medicine Summary and Comment
But who will pay for it?
High-Dose Daptomycin for Device-Related Staphylococcal Endocarditis
Infectious Diseases Summary and Comment
Twenty of 25 patients with this condition were cured (median daily dose, 8.3 mg/kg); none required discontinuation or dose reduction of daptomycin because of adverse events.
By Neil M. Ampel, MD
February 22, 2012
Covering:
Durante-Mangoni E et al., Clin Infect Dis 2012 Feb 1; 54:347
Fried-Food Consumption Not Linked to Heart Disease or Death
General Medicine Summary and Comment
The type of oil used for frying (olive versus sunflower) did not influence the findings.
By Paul S. Mueller, MD, MPH, FACP
February 21, 2012
Covering:
Guallar-Castillón P et al., BMJ 2012 Jan 24; 344:e363
Leitzmann MF and Kurth T., BMJ 2012 Jan 24; 344:d8274
"I'll Be Back"
Hospital Medicine Summary and Comment
Risk-prediction models for hospital readmission perform poorly, according to a systematic review.
Thrombocytosis in Ovarian Cancer: A Not-So-Innocent Bystander?
Tumor cell–induced platelet elevation was shown to stimulate tumor-cell growth and was associated with poor prognosis in ovarian cancer patients.
Who Is at Low Risk for Death After Acute Pulmonary Embolism?
Hospital Medicine Summary and Comment
Free
A simplified risk-assessment tool performed well in predicting 30-day and 90-day mortality in patients with acute pulmonary embolism.
Normalization of Vital Signs Does Not Reduce Risk for Acute Pulmonary Embolism
Emergency Medicine Summary and Comment
Up to one third of patients whose abnormal triage vital signs reverted to normal values had PE.
Preventing Thrombosis During Chemotherapy
Prophylactic anticoagulation with the low-molecular-weight heparin semuloparin reduced the incidence of thromboembolic events without increasing the risk for major bleeding.
By David Green, MD, PhD
February 15, 2012
Covering:
Agnelli G et al., N Engl J Med 2012 Feb 16; 366:601
Akl EA and Schünemann HJ., N Engl J Med 2012 Feb 16; 366:661
Briefly Noted
Increased cardiovascular risk associated with psoriasis, protective effects of cutaneous discoid lupus, treatment for erosive pustular scalp dermatosis, and quality of life in patients with CLE-induced photosensitivity
Pulmonary Hypertension Is Different in Children Than in Adults
Syncope is more common and functional activity is better preserved than in adults. Dyspnea on exertion and fatigue were the most common symptoms.
By F. Bruder Stapleton, MD
February 1, 2012
Covering:
Berger RMF et al., Lancet 2012 Jan 10
Mallory GB Jr., Lancet 2012 Jan 10
Thigh-Length vs. Below-Knee Compression Stockings
Prevention of postthrombotic syndrome was similar with both types of stockings in patients with venous thrombosis, but adverse effects were less common with below-knee stockings.
