Cardiology
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Metabolic Acidosis in the ICU
Sodium bicarbonate therapy for severe metabolic acidemia did not affect a primary composite outcome of all-cause mortality at 28 days and at least one organ failure at day 7. However, in an a priori-defined stratum of patients with acute kidney injury, sodium bicarbonate therapy decreased 28-day mortality and the primary outcome.
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Severe Sepsis and Septic Shock Early Management Bundle
When the Severe Sepsis and Septic Shock Early Management Bundle was used to identify patients with severe sepsis or patients in septic shock, delays in lactate measurements for patients with abnormal lactate levels were associated with delayed initiation of antibiotic therapy and increased mortality.
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Should We Use Early Physical Therapy for Respiratory Muscles?
Mechanically ventilated patients undergoing inspiratory muscle training demonstrated significant increases in both maximum inspiratory and expiratory muscle pressures; the training was associated with reduced weaning duration of 2.3 days.
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A Novel Prediction Tool for Hypoxemia During ICU Intubation
The authors of this retrospective analysis of data from two prospective randomized trials of tracheal intubation created a new risk score calculator to identify patients who may develop severe hypoxemia during this procedure.
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What Is the Key ECG Finding?
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Tafenoquine Tablets (Krintafel)
Tafenoquine is indicated for the radical cure of P. vivax malaria in patients ≥ 16 years of age who have received appropriate antimalarial therapy for acute P. vivax infection.
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Initial Management of Patients With Medication-overuse Headache
As part of a randomized treatment trial for medication-overuse headache, a simple protocol that provided early advice on stopping excessive medications was effective in one-third of patients, even before any prophylactic medications were started.
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Clinicians Prescribe Antibiotics for Excessive Duration in Patients With a Diagnosis of Acute Sinusitis
Clinicians inappropriately prescribe antibiotics most often to patients with a diagnosis of acute sinusitis for durations much longer than recommended.
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Canagliflozin Reduces Risk of Heart Failure Hospitalizations for Diabetic Patients
In type 2 diabetes mellitus patients with a higher risk of cardiovascular disease, canagliflozin lowered the risk of cardiovascular death or heart failure hospitalization. Patients with pre-existing heart failure may experience even greater benefit.
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Substance Abuse and Myocardial Infarction
Among patients ≤ 50 years of age with first myocardial infarctions, use of cocaine or marijuana increased the likelihood of an ST-segment elevation myocardial infarction and the subsequent risk of all-cause and cardiovascular mortality.