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Long-term vasodilator therapy with either nifedipine or enalapril changed neither the hemodynamic burden of severe aortic regurgitation nor reduce or delay the need for valve replacement surgery in asymptomatic patients with chronic severe aortic regurgitation and normal LV function.
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Volume outcome data for percutaneous coronary interventions (PCI) was largely collected and reported in the balloon angioplasty era. Thus, this report from New York state's PCI reporting system from 1998 to 2000 is of interest. This database of over 100,000 cases, which can be adjusted for severity of illness, was interrogated for 3 outcomes: in-hospital mortality, same-day coronary artery bypass surgery (CABG), and same-stay CABG.
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An early invasive strategy did not result in an expected differential in the primary end point.
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Lithium can unmask latent Brugada syndrome by blockade of susceptible cardiac sodium channels.
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Women have a higher risk than men for atrial fibrillation related thromboembolism that is independent of the presence of other risk factors.
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The 79 CC and 46 AA alleles studied were found to be high long term survival, further validating pharmacogenetic targeting of b blocker therapy for improving ACS results.
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In 2001, the PROWESS trial of 1690 patients with severe sepsis1 demonstrated that a 96-hour infusion of activated protein C, or drotrecogin alfa (activated) (DrotAA, Xigris®) at 24 g/kg/h decreased mortality at 28 days from 30.8% to 24.4% (P = 0.005).
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Standard teaching advocates placing a chest tube on water seal in patients with a prior hemothorax or pneumothorax and obtaining a chest radiograph (CXR) the following morning.
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Uncontrolled hemorrhage remains an important cause of death in the ICU. Patients with severe traumatic injuries, gastrointestinal hemorrhage, and ruptured abdominal aortic aneurisms are but a few examples of those who develop coagulopathy and hemorrhage that is not amenable to surgical control and may not respond to traditional approaches to blood product transfusion.
