Cardiology
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VEST: A Positively Negative Clinical Trial
In a randomized trial of the wearable cardioverter-defibrillator prescribed to patients with left ventricular dysfunction after acute myocardial infarction, overall compliance rates were low. The authors observed no significant improvement in arrhythmic death rates; yet, overall mortality was lower.
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LDL Cholesterol: How Low Do We Go?
A meta-analysis of 29 cholesterol-lowering outcome studies with baseline average low-density lipoprotein (LDL) cholesterol levels ≤ 70 mg/dL showed consistent major adverse cardiovascular event risk reductions down to average LDL levels of 21 mg/dL without any increase in adverse events.
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MitraClip Scores Big Win in COAPT
The largest trial to date of MitraClip in highly selected patients with congestive heart failure and functional mitral regurgitation revealed significant reductions in heart failure hospitalization and two-year mortality.
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Migalastat (Galafold) Capsules
Migalastat is indicated for the treatment of adults with confirmed diagnosis of Fabry disease and an amenable galactosidase alpha gene variant based on in vitro assay data.
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Poor Sleep Can Lead to Accelerated Atherosclerosis
New data provide further support for the importance of sleep in the optimization of medical outcomes.
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Coffee Consumption and Mortality
After rigorous evaluation using multiple statistics, an inverse relationship between coffee intake and all-cause mortality was demonstrated consistently across the racial/ethnic groups examined.
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Can Hormone Therapy Prevent the Development of a ‘Dowager’s Hump’?
Postmenopausal hormone therapy may reduce the risk of developing age-related hyperkyphosis, commonly known as a “Dowager’s hump.” Such therapy may provide long-term benefits.
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Carbohydrates, Insulin, and Obesity
Carbohydrate intake stimulates insulin secretion, which is the primary driver of weight gain. Besides driving glucose into cells, insulin causes fat storage, increases hunger, and lowers energy expenditure. High insulin blood levels lead to obesity with some genetic variation.
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Limited English Proficiency Associated With Significant Differences in End-of-life Care
In a retrospective cohort study, patients with limited English proficiency had lower rates of do not resuscitate orders, comfort measures orders, and advanced directives; higher rates of receiving certain types of life support; and longer hospital stays compared to their English-speaking counterparts.
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Can We Prevent Delirium in the ICU?
Low-dose nocturnal dexmedetomidine infusion was shown to prevent delirium in critically ill patients.