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Noninferiority of Seven vs. 14 Days of Antibiotic Therapy for Bloodstream Infections

In this multinational, noninferiority trial that included more than 3,600 hospitalized patients with bloodstream infections from various pathogens and infectious syndromes, seven days of antibiotic therapy was noninferior to 14 days with respect to death from any cause by 90 days. Patients were excluded if they had severe immunosuppression or foci requiring prolonged treatment, or if their blood cultures yielded Staphylococcus aureus or possible contaminants. Various secondary outcomes were similar between the two groups.

Procalcitonin-Guided Care Leads to Shorter Duration of Antibiotics in Sepsis

In this multicenter, intervention-concealed, randomized clinical trial of 2,760 critically ill patients hospitalized with sepsis, the use of a daily procalcitonin-guided protocol resulted in shorter antibiotic duration as compared with standard care, without a significant difference in 28-day all-cause mortality. There was no significant difference in antibiotic duration between patients managed with a daily C-reactive protein-guided protocol and standard care, and the difference in all-cause mortality between these two groups was inconclusive.

Migraine and Ischemic Vascular Disease: The Search for the Missing Link

The presence of traditional vascular risk factors does not explain the increased incidence of ischemic stroke and myocardial infarction in patients with migraine. The use of nonsteroidal anti-inflammatory drugs does not increase the risk of ischemic stroke or myocardial infarction in migraineurs.

Combustible vs. Electronic Cigarettes Post-PCI

A large, nationwide South Korean study of smokers undergoing percutaneous coronary intervention (PCI) has shown that electronic cigarette use and smoking cessation resulted in similarly lower subsequent major adverse cardiac events compared to continued smoking.

Modifiable Cardiovascular Risk Factors and Late-Life Brain Health

The major modifiable risk factors for cardiovascular diseases are delineated in Life’s Essential 8 (LE8), developed by the American Heart Association. These risk factors are blood pressure, glucose, cholesterol, body mass index, smoking, physical activity, diet, and sleep duration. The investigators in this analysis of two large databases in the United Kingdom and the United States demonstrated that cardiovascular health, as defined by the LE8, will also predict brain health later in life.

Treating Hereditary TTR Amyloid Polyneuropathy with Patisiran

A five-year study on patisiran for hereditary transthyretin (TTR) amyloid polyneuropathy found that 65% of patients had stable or improved neuropathy, with better outcomes linked to early treatment. Despite efficacy, 19.4% of patients died. The study underscores the importance of early diagnosis and intervention in managing this progressive disease.

Determinants of Long-Term Outcome After Concussion

This cohort study of U.S. veterans found that mild traumatic brain injuries occurring alongside psychological trauma are associated with long-term post-concussive symptoms and disability. The authors postulate that the traumatic context contributes to the development of post-traumatic stress disorder, which may in turn potentiate long-term sequelae.

Transcranial Magnetic Stimulation and Tai Chi for Older Adults with Sleep Disorders and MCI

This study showed improvement in sleep and cognitive endpoints in patients with sleep disorders and mild cognitive impairment (MCI) treated with a combination of repetitive transcranial magnetic stimulation and tai chi chuan.

Transfusion Therapy in Aneurysmal Subarachnoid Hemorrhage

The SAHARA trial evaluated liberal vs. restrictive red blood cell transfusion strategies in aneurysmal subarachnoid hemorrhage (SAH) patients with anemia. No significant difference in neurological outcomes at 12 months was found. Findings add to existing uncertainty regarding transfusion thresholds in SAH, highlighting the need for further research.

Diagnosis and Outcome of Reversible Cerebral Vasoconstriction Syndrome

Reversible cerebral vasoconstriction syndrome (RCVS) is a rare disorder characterized by thunderclap headaches and cerebral vasoconstriction resolving within 90 days. A retrospective study of 80 patients found favorable outcomes, with most treated using calcium channel blockers. However, challenges in RCVS diagnosis and classification may affect reported outcomes.