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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.

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.

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.

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.

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.

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.

Blood Transfusion in Cardiac Disease Patients

In patients admitted to the ICU with comorbid cardiac disease, the hemoglobin level below which transfusion was associated with lower hospital mortality was < 8-9 g/dL and < 9-10 g/dL if the admitting diagnosis was acute myocardial infarction.

Is Sodium Restriction Detrimental in Chronic Heart Failure?

Dietary sodium restriction may have a detrimental effect on outcome in patients with symptomatic chronic heart failure. They stress that a randomized clinical trial is warranted to resolve the issue.

Optimal Antiplatelet Therapy for Secondary Prevention of Ischemic Stroke

This study strongly suggests that compared with maintaining patients on aspirin alone, switching to a different antiplatelet agent, or adding a second antiplatelet agent to aspirin may be better in preventing subsequent vascular events in patients who experienced a new ischemic stroke while taking aspirin.