Browse Clinical Articles by Topic

Cardiovascular Risk with mRNA COVID Vaccines

A large, nationwide population study in Sweden of the risk of adverse cardiovascular events after messenger ribonucleic acid (mRNA) COVID-19 vaccinations has shown that, except for rare cases of myopericarditis, severe cardiovascular events, such as myocardial infarction, heart failure, and stroke, are reduced, probably because of the prevention of COVID infection.

Indications for Bioprosthetic vs. Mechanical Aortic Valve Replacement

A large U.S. database study comparing mechanical vs. bioprostheses for surgical aortic valve replacement in patients 40 to 75 years of age has shown that all-cause mortality is reduced with a mechanical valve in those age 60 years or younger.

POPular PAUSE TAVI Trial Supports Interrupting Oral Anticoagulation Before TAVR in Patients with Afib

In this investigator-initiated, open-label trial, continuing oral anticoagulation leading up to a transcatheter aortic valve replacement procedure led to more bleeding and no reduction in thromboembolic events compared with interrupting anticoagulation.

Tirzepatide Injection (Zepbound) for Obstructive Sleep Apnea

The U.S. Food and Drug Administration has approved tirzepatide for the treatment of moderate-to-severe sleep apnea in adults with obesity.

Clostridioides difficile: Reduced Susceptibility to Vancomycin?

Many sites have been reluctant to prescribe fidaxomicin as the first-line agent, despite fairly robust evidence indicating its efficacy relative to vancomycin in preventing recurrences. We still cannot predict who will do well with vancomycin and which patients are likely to relapse or to do more poorly. The gradual emergence of Clostridioides difficile with reduced vancomycin susceptibility may contribute to adverse outcomes when using this agent.

Antiplatelet Therapy for Coronary Stent Patients Undergoing Noncardiac Surgery

A larger randomized controlled trial of aspirin monotherapy vs. no antiplatelet therapy in patients more than one year post-drug-eluting coronary stent placement failed to show a difference in ischemic outcomes or major bleeding, but minor bleeding was more common in the aspirin group.

Arrhythmias in the Holiday Heart Syndrome

A small study of continuous electrocardiogram and breath alcohol concentration in young volunteers during acute excessive alcohol consumption has shown that heart rate and ventricular premature beats increased during the drinking period. During recovery (six to 19 hours), significant arrhythmias such as atrial fibrillation occurred in 5% of the subjects. The observed changes in heart rate variability and breath alcohol concentration suggest that these effects are the result of increased sympathetic nervous system activity associated with excessive blood alcohol concentrations.

Reduced Control and Workplace Burnout

This cross-sectional study of more than 2,000 physicians from diverse healthcare organizations found that reduced control over specific aspects of practice — such as patient load, clinical hours, and overall workload — was significantly associated with not only higher levels of burnout, but also increased intentions to reduce clinical hours or leave practice altogether.

Unhurried Patient Care

Unhurried conversations during patient encounters can improve outcomes for patients and enhance career satisfaction of physicians. Specific communication strategies can foster unhurried conversations without adding undue time to clinical care.

Constipation in Adults and Children

Constipation is a common diagnosis that has been steadily increasing in prevalence over the past several decades. As the morbidity and healthcare costs from this condition increase, it is important that physicians be aware of the workup, management, and potential complications of this common condition in adults and children alike.