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Research summaries with expert commentary
Repair within 24 hours was associated with lower complication rates and lower 30-day mortality.
Definitely more than necessary at teaching centers compared with nonteaching centers.
DOACs appeared to be at least as effective as warfarin, with less bleeding risk.
Does Low-Dose Aspirin Increase Risk for Intracranial Bleeding?
Many of these products, marketed to athletes and muscle builders, aren't what they seem to be.
At 6 months, shoulder pain outcomes were similar among patients who underwent ASD and those who did not.
Contradicting a recent, high-profile study, a meta-analysis suggests that only 1% of syncope patients have pulmonary embolus.
A national database provides a snapshot of palliative care−team involvement in clarifying goals of care.
For common surgical procedures, 7 days usually sufficed for opioid-naive patients, but duration depended on the type of procedure performed.
Interviews with nephrologists from the U.S. and England describe barriers to withholding dialysis, especially in frail elders.
Routine evaluation might be equivalent to extensive screening.
A research team suggests that a 25-hydroxyvitamin D level of 12 ng/mL (30 nmol/L) might be a more appropriate cutoff.
Only a small proportion of patients derived benefit from these drugs, and the benefit was modest.
A meta-analysis casts doubt on this enduring belief.
Earlier diuretic initiation was associated with lower mortality. But why?
A single-center study showed remarkable mortality reduction with this cocktail.
A novel schema for presenting surgical risks to frail elders might help foster better care.
In a large multicenter cohort of blunt trauma patients, 24% had rib fractures and two thirds of these were missed by plain films.
Sicker patients, and not staffing, might explain this observation.
In a group of mostly afebrile, largely nondiabetic patients, cephalexin did well by itself.
In a secondary analysis from a randomized trial, pravastatin did not lower 6-year cardiovascular-related mortality.
Overall 6-month mortality was 17% after dialysis initiation.
A single injection reduced pain at 1 month but not thereafter.
Blausen.com staff (2014). "Medical gallery of Blausen Medical 2014". WikiJournal of Medicine 1 (2). DOI:10.15347/wjm/2014.010. ISSN 2002-4436. (Own work) [CC BY 3.0 (http://creativecommons.org/licenses/by/3.0)], via Wikimedia Commons
By Hopur2 (Own work) [CC BY-SA 3.0 (http://creativecommons.org/licenses/by-sa/3.0)], via Wikimedia Commons
Appropriate use of prothrombin complex concentrate and specific reversal agents are recommended.
Excess risk for hyponatremia at 30 days was small but statistically significant.
Investigators found slightly higher risk for cardiac arrest or intensive care unit transfer in the 6 hours after an index patient's critical event.
When antibiotics for unrelated infections are needed, a short course of oral vancomycin might preempt C. diffile recurrence.
On serial chest computed tomography scans done 6 years apart, these abnormalities were detected in 8% of adults.
In a randomized trial, delirium symptoms were less severe with placebo than with risperidone or haloperidol.
This rheumatoid arthritis drug was associated with excess lower gastrointestinal perforations.
A new study shows a persistent 10% rate, in contrast to CDC data.
Home-based and nursing home–based palliative care interventions were associated with fewer hospitalizations near the end of life.
But differences in adherence between PCMH practices and other medical practices were small.
This disorder has a poor prognosis; thrombophilias frequently are associated with it.
Almost half of all antibiotics prescribed for otitis media, sinusitis, and pharyngitis were non–first-line choices.
A survey of clinicians revealed several beliefs that might explain inappropriate imaging.
Results were not particularly impressive in a real-world observational study.
Almost all low-risk patients with febrile neutropenia in this study were either unnecessarily admitted or given unnecessary parenteral antibiotics.
Compression rates of 120–140 per minute increased odds of return of spontaneous circulation relative to the guideline-recommended rate of 100–120.
From 2007–2012, sexual activity rates did not change but contraceptive use increased.
About one third of travelers acquired extended-spectrum β-lactamase–producing bacteria, but most were of low pathogenicity, and no clinical infections occurred up to 26 months later.
Core body temperature and heart rate actually rose slightly.
Triple-rule-out CT identified clinically significant, previously undiagnosed conditions in 8.9% of patients.
High concentrations of RSV were found in small-particle aerosols within 1 meter of hospitalized infants and children with bronchiolitis.
Integration of cognitive and motor training lowered the incidence of falls.
Just over a quarter of patients underwent testing for ischemia within 90 days of HF hospitalizations.
This systematic review shows a high rate of PE in patients hospitalized for exacerbation of chronic obstructive pulmonary disease.
For women discontinuing estrogen-containing contraceptives to attempt pregnancy, clinicians should consider advising use of multivitamins containing vitamin D and folic acid.
Most older adults do not use digital technologies for everyday or health-related activities.
Results support the current conservative strategy for blood transfusion in these patients.
In a meta-analysis, accuracy depended somewhat on volume and number of swallows.
In an observational study, statins were not associated with significantly lower mortality.
Coprescribing naloxone was associated with fewer opioid-related emergency room visits.
Symptoms such as cognitive troubles, bradykinesia of hands and fingers, and distal sensory neuropathy were common but transient.
Differing perceptions were driven by miscommunication and differences in beliefs.
Frailty was associated with strikingly higher 30-day and 1-year mortality after many major surgeries.
Heavy alcohol consumption and cigarette use were more common in these groups than in heterosexual peers.
Dying patients with cancer or dementia receive better care than those with other diagnoses.
Extended-spectrum antibiotics offer no advantage over narrower-spectrum antibiotics when treating appendicitis.
In a large observational study, these drugs compared favorably with warfarin.
Two studies present conflicting results.
Opioids provided some short- and intermediate-term pain control, but the effect wasn't clinically meaningful.
Early administration of antibiotics and use of objective criteria to transition from intravenous to oral therapy are beneficial.
Prolonged anticoagulation reduced VTE in high-risk patients but increased bleeding.
Waiting until bladder volume reaches 800 mL is reasonable.
One episode of hyperglycemia can be expected for every eight patients treated for 1 year with this combination.
A laboratory utilization dashboard did not change ordering habits among internal medicine residents.