Articles Tagged With:
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Does Thoracentesis Speed Recovery from Heart Failure?
An unblinded, multicentered, randomized trial of patients with acute heart failure hospital admissions and significant pleural effusions showed that early thoracentesis, in addition to recommended medical therapy, did not reduce mortality or length of stay, or increase days alive out of the hospital for 90 days. However, it was relatively safe and could be employed in selected persistently symptomatic patients with very large effusions.
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Stroke Risk in Patients with New AFib During Unrelated Hospitalization
In a Canadian administrative database study of patients who developed atrial fibrillation during a hospitalization for other reasons, researchers followed the patients for one year to ascertain the risk of subsequent stroke. The incidence of stroke in those not anticoagulated generally was below the 2% per year threshold recommended for treatment with anticoagulants. However, in those with a CHA2DS2-VA score ≥ 5 (sex not included based on new data) and in those admitted for cardiac medical problems, the 95% confidence intervals of stroke risk did cross 2%. Thus, selected patients may be candidates for anticoagulation.
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Pediatric Airway Management: The Basics
Pediatric airways present unique challenges to all acute providers. Knowing what to use and when to use it is critical, and being prepared for the most basic and difficult situations is essential. The authors present a comprehensive, escalating review on the approach to a child’s airway to optimize outcomes.
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Epigenetic Changes in Perilesional Brain Tissue After Radiotherapy
Epigenetic and transcriptomic studies of irradiated perilesional brain tissue identified clear changes in deoxyribonucleic acid (DNA) methylation patterns and neuropeptide upregulation that contributed to neuroinflammation, which may underly radiation-related neurotoxicity.
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24-Hour Activity Rhythms and Amyloid-β Deposition in the Brain
This study of dementia-free adults found that greater variability of the 24-hour activity rhythm (greater during the daytime as well as during sleep time) with fragmentation of sleep predicted increased deposition of amyloid-β (Aβ), especially in apolipoprotein E 4 (APOE4) carriers.
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Quantitative Pupillometry in Patients with Large Middle Cerebral Artery Strokes
Secondary neurologic decline after large middle cerebral artery (MCA) stroke is common and is associated with worse outcomes. This study aimed to evaluate the utility of quantitative pupillometry to predict neurologic decline before it occurs. Although no model was found to predict decline, stable Neurological Pupil index (NPi) and dilation velocities may provide some reassurance that an imminent decline is unlikely.
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TIA Is Associated with Accelerated Cognitive Decline
The study investigators looked at data from a prospective study of 30,239 Black and white community-dwelling persons aged 45 years or older with cognitive evaluations over the phone every other year until 2022. The researchers documented patients who had transient ischemic attack (TIA) or stroke, and demonstrated that persons who had TIA had a cognitive decline trajectory similar to those patients who had a definite diagnosis of stroke.
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Clinical Features of Biopsy-Proven Large-Arteriole and Microvasculitis in Peripheral Nerves
In this retrospective, an observational cohort study undertaken to characterize the clinical features of nerve vasculitis based on vessel size, large-arterial vasculitis (≥ 75 microns) in comparison to microvasculitis (< 75 microns) was demonstrated. Large arteriole vasculitis usually was a distal symmetrical polyneuropathy and associated with a systemic vasculitis illness. Microvasculitis most often presented with radiculopathy and/or plexopathy and was not associated with systemic illness.
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Modern Pharmacotherapy in Obesity: Evidence-Based Approaches for Effective Management
Obesity poses a significant public health and economic burden, contributing to numerous chronic conditions. This review provides primary care providers with a concise overview of U.S. Food and Drug Administration-approved pharmacotherapies for obesity management, including incretin-based treatments that rival bariatric surgery in efficacy. It emphasizes the importance of aligning pharmacologic options with individual patient profiles and comorbidities, reinforcing that lifestyle modification remains a critical component of successful, sustained weight loss.
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Infectious Disease Updates
Mpox Accelerates in Africa; Why Does Colonization Become Active C. difficile? Avian Influenza in Felines Exposed to Dairy Workers