Cardiology
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Why Dentists Are Suddenly Smiling
In this meta-analysis of 51 randomized, controlled studies that included nearly 5000 patients, continuous positive airway pressure and oral appliances resulted in comparable and statistically significant reductions in blood pressure.
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Diabetes, Dementia, and Hormones
Higher levels of estrogen may exacerbate risks that type 2 diabetes pose for cognitive function decline in older women.
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Delay in Performing Endovascular Reperfusion Results in Worse Disability Outcomes
In the past year, multiple clinical trials have reported that intra-arterial endovascular reperfusion with mechanical clot extraction, using the SOLITAIRE stent retriever device and others, results in better neurological outcomes than treating patients with intravenous thrombolysis alone with TPA. There is still uncertainty regarding the maximum time window, and how important early intervention is as related to neurological recovery and long-term outcomes.
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Spironolactone for Resistant Hypertension
Resistant hypertension is common, and the choice of additional drug therapy in this condition is not clear.
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Clinicians Are Skeptical of Early Warning Systems for Sepsis
Severe sepsis is very common, with high morbidity and mortality. Early recognition and intervention improves mortality. However, the diagnosis may often be missed in early sepsis. An academic health system developed an electronic early warning and response system for sepsis in 2012, monitoring real time vital signs and laboratory data for hospitalized, non-ICU, acute care patients and notifying clinicians when specific criteria were met. -
Bedside Ultrasound: Is It a Reliable Tool for Guiding Resuscitation in Patients with Undifferentiated Hypotension?
The use of bedside ultrasound has expanded tremendously over the last few decades. As it is readily available and relatively inexpensive, ultrasound provides the opportunity to examine hypotensive, critically ill patients, potentially leading to a faster, more accurate diagnosis.
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Sepsis Resuscitation and Mortality
The use of balanced salt solutions rather than isotonic saline or colloids may improve in-hospital mortality in patients admitted with septic shock.
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Prescient Warning Symptoms: A New Target for Sudden Cardiac Death Prevention
Typical cardiac symptoms frequently precede sudden cardiac arrest and are frequently unheeded, but when acted on are associated with decreased mortality.
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Five-year EVEREST II Results Allay Long-term Safety and Durability Concerns About MitraClip
Although MitraClip patients had higher rates of re-operation in the first year, adverse event rates in the 1- to 5-year range were reassuringly low and were comparable with surgery.
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Selecting Patients for Statin Primary Prevention
The new vascular disease risk calculator discriminates who will experience a vascular event in the near future better than using a trial entry criteria approach or a hybrid approach.