Cardiology
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Vitamin D and Colorectal Cancer: The Plot Thickens
In a follow-up study, researchers investigated whether single nucleotide polymorphism (SNP) genotypes in the vitamin D and calcium pathways are associated with the authors’ previous findings that daily intake of 1,000 IU vitamin D3 and/or 1,200 mg calcium did not reduce colorectal adenoma risk. The authors concluded that vitamin D3 supplementation benefits in the prevention of advanced colorectal adenomas may vary depending on vitamin D receptor genotype status.
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Physician Burnout: A Multi-specialty Perspective
Although different specialties address the problem of physician burnout, studies suggest the most effect is gained from organizational interventions.
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Caring for Providers: Mindfulness for Healthcare Practitioners
Preliminary studies show some promise for use of mindfulness interventions in healthcare practitioners, but the time required for training medical providers in these techniques is identified as a limitation to implementation.
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Angiotensin II Raises Blood Pressure in Patients with Vasodilatory Shock
The ATHOS-3 trial represents an important proof of concept trial regarding angiotensin II as a new vasopressor in the armamentarium to treat vasodilatory shock.
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Natriuretic Peptide-guided Therapy Does Not Improve Systolic Heart Failure Outcomes
A recent meta-analysis of 11 trials showed a significant reduction in all-cause mortality with natriuretic peptide-guided therapy, although the individual trial results varied substantially.
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Is a Dabigatran Reversal Agent Effective?
Dabigatran is an attractive oral anticoagulant for patients who demonstrate indications for oral anticoagulation but are at high risk of bleeding.
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In-hospital vs. Telephone Availability of an Intensivist at Night
When overnight shifts were staffed by nighttime intensivists rather than residents with attending intensivists on call remotely, most nurses perceived improvements in clinical care, procedures, efficiency, communication, and job place comfort.
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Is There Still a Role for High-frequency Oscillatory Ventilation in ARDS?
In this patient-level meta-analysis of four well-known randomized, controlled trials of high-frequency oscillatory ventilation (HFOV) in acute respiratory distress syndrome (ARDS), the authors found that HFOV increases mortality for most patients with ARDS but may improve survival among patients specifically with severe ARDS.
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Hyponatremia in the Critically Ill
Hyponatremia is the most common electrolyte disorder encountered in hospitalized patients (30-40%) and is present in 17.7% of patients admitted to the ICU. A recent registry demonstrated significant practice variation regarding this common disorder, underlining the frequent diagnostic and therapeutic challenges clinicians face in this area.
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Transcatheter Mitral Valve Replacement as an Alternative to Other Surgical Options
A large registry study of transcatheter mitral valve replacement (TMVR) in patients with degenerated mitral valve bioprostheses or failed mitral annuloplasty repairs who were at high risk for repeat surgery showed that TMVR can be performed successfully. However, the initial and long-term results are better in the degenerated bioprothesis group.