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Rapid Triage Testing Could Improve Outcomes for Patients with Acute Kidney InjuryDavid Ludvigson and Nam Tran, PhD, write about the need for rapid triage testing as a method of improving outcomes for patients with acute kidney injury.
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So when should sinus rhythm be restored?This review summarizes an important substudy of the Rate Control Versus Electrical Cardioversion (RACE) trial, which randomized 522 patients with atrial fibrillation (AF) to rate versus rhythm control treatment strategies and followed them for up to 2.3 years with a primary composite endpoint that included cardiovascular mortality, heart failure, thromboembolic complications, bleeding, severe adverse effects of anti-arrhythmic agents, and pacemaker implantation.
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How a Cruise Can Simplify Your VacationCruises not only simply the vacation experience, but they also enable visits to countries that might be difficult to navigate otherwise.
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Gene Therapy Shows Promise in Neutralizing HIVResearchers safely infuse engineered immune cells in groundbreaking gene therapy study.
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Double infarct syndrome: Simultaneous subacute ST-segment elevation myocardial infarction involving the right coronary and the left circumflex arteriesRuptured or vulnerable plaques exist not only at the culprit lesion but also in the whole coronary artery in some acute coronary syndrome (ACS) patients.Goldstein et al found features of instability of nonculprit plaques in nearly 40% of patients by angiography,1 whereas actual rupture in a remote site other than the angiographic culprit lesion was found in approximately 13% to 79% of cases when evaluated by intravascular ultrasound.
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Intracranial hemorrhage in atrial fibrillation: Is there a racial/ethnic difference?We evaluated a multiethnic cohort of subjects with nonrheumatic atrial fibrillation hospitalized over a 6-year period to determine the racial and ethnic differences in the risk of intracranial hemorrhage (ICH) and the effect of warfarin treatment on ICH risk. Treatment with warfarin was associated with a 2-fold greater risk of ICH in whites, a 4- to 5-fold greater risk in both blacks and Hispanics, and a 15-fold greater risk in Asians. After adjusting for established stroke risk factors and warfarin use, Asians were 4 times as likely as whites to have ICH, whereas blacks and Hispanics were twice as likely.
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Smartphones Moving to the Front Line of Mobile Technology for PhysiciansTraditionally, physicians have relied on textbooks, conferences, and, more recently, the Internet to keep abreast of the latest clinical data and support clinical decision-making
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How Should I Manage This Man's Hyperthyroidism?Though laypeople are sensitized to associating "radioactive" with "cancer," this is an unwarranted fear when considering radioactive iodine ablation for hyperthyroidism.
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Mortality of patients with diabetes mellitus and acute myocardial infarctionWe evaluated trends in the treatment and mortality of patients with and without diabetes mellitus and acute myocardial infarction over the last decade. Despite improvements in the provision of evidence-based care, patients with diabetes did not derive improvements in long-term survival.
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Body mass index and risk of stroke in womenAlthough several studies have found a positive association between body mass index (BMI) and stroke in men, the association in women is less clear. We evaluated women enrolled in the Women's Health Study and found that increased BMI was a strong risk factor for total and ischemic stroke. These results show that the number of total and ischemic strokes may be reduced if obesity is prevented.
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Chronic diuretic use and increased mortality and hospitalization in heart failureDiuretic use is associated with activation of neurohormones and disease progression in heart failure. Yet, diuretics are commonly prescribed, although little is known about their long-term effects. We performed a study based on propensity score matching, which indicated that in subjects with ambulatory, chronic, mild-to-moderate heart failure, diuretic use was associated with increased mortality and hospitalization. These findings call into question the wisdom of using long-term diuretic therapy in heart failure patients who are asymptomatic or minimally symptomatic.
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Neurobiological and Neuropsychiatric Mechanisms of Fibromyalgia and Their Implications for TreatmentThe variety of mechanisms that play a part in pathologic pain perception leads to a great deal of complexity and variation in the clinical presentation and severity of fibromyalgia symptoms, as well as a high degree of variability in patient response to treatment.
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Prediction of coronary artery disease in patients with diabetes and albuminuriaWe developed a set of equations to predict the risk or probability of developing coronary artery disease (CAD) in 10 years among American Indians. The equations are based on the significant risk factors identified in the Strong Heart Study, a longitudinal study of cardiovascular disease in American Indians. The equations can be used in patient education and to evaluate the efficacy of CAD prevention and intervention programs.
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Can the CDC Prevent Ebola in the US?We trusted the US Centers for Disease Control and Prevention to contain Ebola. But then three health care workers got it. Wouldn't we be better off with a moratorium on flights from the Ebola hot zone?
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Final Thoughts on the Opioid Crisis and Normalizing NaloxoneThe multidisciplinary panel of experts share final thoughts on strategies to normalize naloxone and decrease barriers to its obtainment and utilization.
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Elevated high-density lipoprotein cholesterol and carotid atherosclerosisWe assessed the relationship between high-density lipoprotein (HDL) cholesterol level and carotid plaque progression in 1952 men and women with preexisting carotid atherosclerosis over a period of 7 years. The HDL cholesterol level was inversely related to plaque growth. The plaques that became more echogenic during follow-up had a lower growth rate compared with those that became more echolucent. These findings suggest that HDL cholesterol stabilizes plaques and counteracts their growth by reducing their lipid content and inflammation.
