Emphysematous pancreatitis is typically managed with broad-spectrum antibiotics and early surgical debridement. Here, a case that supports more recent evidence for conservative therapy.
Extensive condylomata acuminata are beyond the capacity of all topical therapies. The area was initially treated by carbon dioxide laser ablation, and residual small foci of infection were subsequently treated with topical 5% imiquimod cream.
For a patient with atrial fibrillation whose risk of ischemic stroke is low, is antiplatelet therapy the right choice? A revised risk calculation formula, based on the original CHADS2 criteria, restratifies low-risk patients to further help identify those who may not require oral anticoagulation.
How aldosterone antagonism achieves this reduction is uncertain, but the study highlights this class as an important treatment option to consider in patients with HF and AF.
In the first study to observe the association, Hsu et al found that CD4+ count and viral load were complementary and independently associated with increased incidence of AF in persons with HIV.
Post–hoc analysis of data from the ROCKET-AF trial found similar rates of stroke and systemic emboli after treatment interruption for rivaroxaban and warfarin in 2 out of 3 study cohorts. A very different result was found in the third. More, here.
Could the left atrial appendage closure device, known as the Watchman device, become an alternative to oral anticoagulation for selected patients? Here, more on the 2 trials that have introduced the possibility.
Here: how omega-3 fatty acids may help reduce the risk of AF in postcardiac surgery patients; how incident HF can help predict long-term adverse outcomes in patients with AF; and why an old gout drug may help reduce the risk of AF in patients with heart failure.
A recent meta-analysis of beta-blocker use in patients with HF found that the drugs conferred no reduction in rates of mortality or hospitalization among patients with comorbid AF. What are the implications for clinical practice?
ABSTRACT: A key objective in the follow-up of women with a history of breast cancer is the detection of local and distant disease at a curable stage. Regular clinical examination and yearly mammography are the standard of care. No consistent evidence supports annual chest radiography, bone... More »
ABSTRACT: Age-related anatomic and physiologic alterations in the thyroid gland have a variety of clinically important effects. Hypothyroidism, which is common in older persons, raises cholesterol and triglyceride levels; hyperthyroidism may be masked by the severity of the cardiac problems... More »
A 69-year-old retired accountant presents with a 2-month history of daily headaches. The pain is moderate, constant,
global, pressure-like, and occasionally pulsating; it is sometimes exacerbated when the patient lies down. He denies nausea
or vomiting, ocular symptoms, weakness, or sensitivity to... More »
A 77-year-old man is brought to the emergency department after several
days of illness that began with fever, nausea, emesis, and headache. Muscle
weakness and associated myalgia developed; the weakness became so severe
that the patient needed help to get out of bed and walk to the bathroom.
The day... More »
A 78-year-old man presented to the
emergency department with a 3-week
history of progressive shortness of breath
and cough with blood-streaked, yellowish
sputum. The patient had dyspnea on
exertion limited to 2 blocks, 2-pillow
orthopnea, paroxysmal nocturnal dyspnea,
and nocturia. Neither fever nor... More »
ABSTRACT: For patients who present with ventricular fibrillation (VF) or pulseless ventricular tachycardia that is refractory to repeated countershocks, the drug of choice is amiodarone; the recommended dose for those who are receiving cardiopulmonary resuscitation is 300 mg given as an IV... More »
More than
1.8 million
cardiac
catheterizations
and
at least 600,000 percutaneous
transluminal coronary
angioplasty (PTCA)
procedures are performed
in the United States annually.
1 The use of these diagnostic
and interventional
modalities continues to
grow even as financial constraints
increase. Yet... More »
During a routine office visit, a 64-year-old woman who has had type 2 diabetes
for more than 10 years complains of increased pedal edema. The edema is minimal
on awakening and worsens throughout the day. More »
Primary Care Can't Thrive Without Nurse Practitioners Courtney H. Lyder, ND, May 17, 2013 With a projected shortfall of primary-care physicians, it's time for alternate solutions to patient care. Nurse practitioners are one logical remedy.