Articles Tagged With:
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Ambulatory BP Monitoring
The benefits of hypertension treatment (HTN), often cited as a 25% reduction in myocardial infarction, 40% reduction in stroke, and 50% reduction in heart failure, have generally been demonstrated in clinical trials based on an office blood pressure measurement. Since a substantial minority of patients enrolled in HTN trials — approximately one-third according to numerous estimates — ultimately turn out to have white coat HTN (wc-HTN), we may be underestimating the actual benefits of HTN treatment. Patients with wc-HTN do not suffer the same increased risk of cardiovascular events as HTN patients; hence, their inclusion in HTN trials “dilutes” treatment effects.
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The Vitals - March 2015
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Options Expand for Women
The FDA has approved a new intrauterine device that will be offered on the commercial market and at a reduced cost to some public health clinics.
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Overview and Instructions
Read each of the following sections. CME Questions are presented inline with links to begin the CME Post-Test. -
Pulmonary Embolism
For emergency physicians, acute pulmonary embolism (PE) provides a particularly complex diagnostic challenge. It has been estimated that 650,000 to 900,000 individuals annually suffer a fatal or nonfatal acute pulmonary embolism.1 While the classic textbook clinical presentation is well known, it is insufficiently accurate and precise in the timely diagnosis of an acute PE. In addition, many patients presenting with seemingly typical exacerbations of their underlying cardiopulmonary disease or other chronic illness may be masking symptoms of an undiagnosed acute pulmonary embolism.2 The high acuity coupled with the unreliable clinical presentation led to the development of several clinical tools, laboratory diagnostics, and radiographical studies to increase the clinician’s diagnostic power. This article we will review the Geneva Score and Wells Criteria, as well as the Kline and PERC rules. In addition, it will discuss special patient populations and diagnostic modalities for treating pulmonary emboli.
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Fewer Deaths, Lower Costs by Reducing Hospital-acquired Conditions
An estimated 50,000 fewer patients died in hospitals and about $12 billion in healthcare costs was saved by reducing hospital-acquired conditions.
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HHS to Emphasize Quality, Not Quantity
Is Medicare’s latest push about physician pay just another pie-in-the-sky initiative?
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When What Looks Like Strep Is Something Else
Lemierre's syndrome is making a comeback in adolescents and young adults.
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Bridging During Anticoagulation Interruptions Is Associated with Worse Outcomes
Despite the routine nature of discontinuing atrial fibrillation (AF) patients’ long-term oral anticoagulation (OAC) for procedures and “bridging” them with another agent, there is remarkably little data on the safety and benefit of this practice. Guidelines detailing when and how to initiate bridging therapy have been published, but data supporting why we should bridge at all are limited.1 To help fill this void, Steinberg and colleagues used a national, community-based registry of outpatients with AF (ORBIT-AF) to examine current practices around periprocedural OAC management and associated outcomes. Outcomes evaluated included rates of major bleeding, as well as myocardial infarction, stroke or systemic embolism, cause-specific hospitalization, and death within 30 days.
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Intravenous Fluids in Patients With Acute Heart Failure
MONOGRAPH: Volume overload is a hallmark of acute heart failure. In hospitalized patients, intravenous loop diuretics are the most common treatment for decongestion.