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Outcomes in Patients Treated with Therapeutic Hypothermia After In-hospital Cardiac Arrest

SYNOPSIS: Current guidelines recommend the use of therapeutic hypothermia in patients with in-hospital cardiac arrest, even though its efficacy has been demonstrated only in randomized trials after out-of-hospital cardiac arrest. This non-randomized, observational cohort study based on a large national registry found that the use of therapeutic hypothermia was associated with lower likelihood of survival and less favorable neurological outcome in patients successfully resuscitated after an in-hospital cardiac arrest.

Recently Diagnosed Idiopathic Dilated Cardiomyopathy Patients Are at Risk for Major Arrhythmic Events

Patients with recently diagnosed idiopathic dilated cardiomyopathy are at marked risk of major arrhythmia events that are neither well-predicted by traditional methods nor protected against by defibrillator implantation more than three months after diagnosis.

Diastolic Blood Pressure Goals

An analysis of the community-based ARIC study showed that low diastolic blood pressures were associated with higher baseline and subsequent troponin T levels and adverse cardiac events, but not stroke.

MitraClip Experience in Functional Mitral Regurgitation

A post-regulatory approval, observational study of patients with symptomatic functional mitral regurgitation stratified by baseline left ventricular ejection fraction (LVEF) showed that these patients received substantial benefit at low rates of hospital mortality and other adverse events, regardless of baseline LVEF.

Left Main Confusion: Two Randomized Trials Reach Seemingly Opposite Conclusions

The NOBLE and EXCEL trials randomized patients presenting with left main disease to treatment with percutaneous coronary intervention or coronary artery bypass graft.

Spironolactone Improves Exercise Capacity in Diastolic Heart Failure

In a small randomized, controlled trial of patients presenting with heart failure with preserved ejection fraction, treatment with spironolactone was associated with improved exercise capacity and less exercise-induced increase in left ventricular filling pressures.

Infectious Disease Alert Updates

Wee Bacterium Parasitizes Other Oral Bacteria; How Safe Is Your Honey?; Benefits of TB Screening Confirmed

Can the Human Papillomavirus Vaccine Cure Cervical Dysplasia?

In this randomized, controlled trial, the HPV 16/18 vaccine did not hasten resolution of existing oncogenic HPV infections nor prevent persistent HPV 16/18 associated infection and cervical dysplasia recurrence after loop electrosurgical excisional procedure treatment.

VRE and MRSA: Should We Stop Routine Contact Precautions?

The value of routine contact precautions for VRE and MRSA is strongly challenged.

Empirical Antifungals in the ICU — Probably Not Helpful

Two hundred sixty non-neutropenic ICU patients with clinical evidence of sepsis receiving broad-spectrum antibiotics and known to be colonized by Candida species were randomized to micafungin for 14 days vs. placebo. Empirical micafungin therapy did not increase invasive fungal infection-free survival at 28 days.