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CTU remembers Michael Rosenberg, MD, MPH
The reproductive health research community is paying tribute to Michael Rosenberg, MD, MPH, founder and chief executive officer of the Durham, NC-based clinical research organization, Health Decisions. Rosenberg was killed in a Dec. 8 plane crash in Maryland.
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For Methods that are Reversible and Long-acting, the Upswing Continues
Our annual contraception survey shows “dramatically more” women choosing intrauterine and implant contraception.
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Risk of Stroke with Intracardiac Devices and Patent Foramen Ovale
After some case reports of stroke due to electrophysiology (EP) device thrombosis in patients with a patent foramen ovale (PFO), concern has been raised about the risk of stroke with intracardiac devices in patients with known PFO. Thus, these investigators from the Cleveland Clinic did a retrospective database study of 2921 echocardiography-detected PFO patients and categorized them as having an EP device (231) or not.
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Late Tricuspid Regurgitation After Heart Valve Surgery
Due to the success of left heart valve disease surgical corrections, patients may experience late tricuspid regurgitation.
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Coronary Stents and Noncardiac Surgery
Contemporary data suggest that approximately one in every five patients will require non-cardiac surgery within two years of coronary stent implantation.
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Spironolactone & the Potential Benefit for HFPEF Patients
No treatment has been shown to improve outcomes in heart failure with preserved ejection fraction.
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Revascularization for Isolated Proximal LAD Disease: PCI is Easiest, but is it Best?
Among patients with obstructive coronary disease requiring revascularization, guidelines would suggest a clear preference for coronary artery bypass grafting (CABG) over percutaneous coronary intervention (PCI) only in certain defined subsets, including those with left main disease and in diabetics with multi-vessel disease. Patients with isolated proximal LAD disease represent a unique high-risk subset of those with single-vessel disease, in that the size of the affected territory and associated ischemic risk makes CABG a viable option. In fact, U.S. guidelines currently assign a slight advantage to CABG with a left internal mammary graft to the left anterior descending (LAD) for such patients, rating this as a IIa indication vs a IIb recommendation for PCI. This is despite a relative paucity of data on this subset of patients, at least using contemporary treatments. In fact, of the nine randomized, controlled trials forming the basis for 17 published studies examining this question, most are quite small, and all but one were performed using bare-metal stents; the single small RCT incorporating drug-eluting stents (DES) used first-generation devices that are no longer part of the treatment landscape.
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Progress lags on needlestick prevention
Needlestick injuries remain stubbornly common, despite a long-standing federal law and worker safety regulations requiring an annual review of safety devices. Forging a path to improvement requires collaboration with hospital purchasing and quality improvement, says the coordinator of the nation’s most comprehensive needlestick surveillance system.
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New model significantly reduces boarding of psychiatric patients
No problem has proven more vexing to ED leaders in recent years than the issue of boarding related to patients with mental health concerns. It is not unusual for these patients to be held in the ED for hours, if not days, before a psychiatric bed is found. This has the effect of running up the healthcare tab while bogging down throughput, and it leaves virtually no one satisfied.
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Actively engage patients following these simple tips
Evidence-based health coaching (EBHC), a novel approach to engaging patients, combined with motivational interviewing can produce lasting change because it delves into the reasons behind patients’ resistance, one expert says.