Articles Tagged With:
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Arrhythmias in the Holiday Heart Syndrome
A small study of continuous electrocardiogram and breath alcohol concentration in young volunteers during acute excessive alcohol consumption has shown that heart rate and ventricular premature beats increased during the drinking period. During recovery (six to 19 hours), significant arrhythmias such as atrial fibrillation occured in 5% of the subjects. The observed changes in heart rate variability and breath alcohol concentration suggest that these effects are the result of increased sympathetic nervous system activity associated with excess blood alcohol concentrations.
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Catheter Ablation for Ischemic Ventricular Tachycardia
A multicenter, randomized trial of initial catheter ablation vs. antiarrhythmic drug therapy for ventricular tachycardia in ischemic cardiomyopathy patients with an implantable cardioverter defibrillator resulted in fewer subsequent ventricular tachycardia episodes with ablation.
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Antiplatelet Therapy for Coronary Stent Patients Undergoing Noncardiac Surgery
A larger randomized controlled trial of aspirin monotherapy vs. no antiplatelet therapy in patients more than one year post-drug-eluting coronary stent placement failed to show a difference in ischemic outcomes or major bleeding, but minor bleeding was more common in the aspirin group.
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Angiography-Based QFR Analysis Falls Short Compared with FFR
In this large, multicenter, randomized trial, use of the angiography-based quantitative flow ratio method to guide revascularization of intermediate coronary stenoses resulted in a higher incidence of major adverse cardiac events at one year compared with pressure wire-based fractional flow reserve.
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Infectious Disease Updates
Clostridioides difficile: Reduced Susceptibility to Vancomycin? Antibiotics Reduce Culture Yield in Joint Infection
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Unhurried Patient Care
Unhurried conversations during patient encounters can improve outcomes for patients and enhance career satisfaction of physicians. Specific communication strategies can foster unhurried conversations without adding undue time to clinical care.
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Procalcitonin-Guided Care Leads to Shorter Duration of Antibiotics in Sepsis Patients
In this multicenter, intervention-concealed, randomized clinical trial of 2,760 critically ill patients hospitalized with sepsis, the use of a daily procalcitonin-guided protocol resulted in shorter antibiotic duration as compared with standard care, without a significant difference in 28-day all-cause mortality. There was no significant difference in antibiotic duration between patients managed with a daily C-reactive protein-guided protocol and standard care, and the difference in all-cause mortality between these two groups was inconclusive.
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Aeromonas Infections — Do Not Go Near the Water
Infection with Aeromonas mostly involves skin and soft tissue and traumatic wounds occurring with exposure to water contaminated by the organism. The organism often is resistant to carbapenems because of the presence of a chromosomal carbapenemase, while often remaining susceptible to third-generation cephalosporins.
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Parvovirus and Increasing Danger in Pregnancy and Sickle Cell Disease
The incidence of human parvovirus B19 infection is increasing in the United States, putting vulnerable groups at risk of serious complications.
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Intrauterine Instillation of Mepivacaine at the Time of IUD Placement
In a randomized clinical trial of 151 women, intrauterine instillation of mepivacaine significantly reduced pain with intrauterine device insertion on visual analog scales both before (53.9 mm vs. 67.2 mm, respectively; P < 0.001) and after adjustment for individual provider variability (55.2 mm vs. 77.4 mm, respectively; P < 0.001), compared to placebo.