The American journal of medicine
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Acute renal failure has important prognostic implications in critically ill patients, but the effects of acute renal failure on in-hospital mortality in the subset of patients with cardiogenic shock are not known. ⋯ Acute renal failure was common in patients with cardiogenic shock and strongly associated with in-hospital mortality.
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Comparative Study
Triage of patients with chest pain in the emergency department: a comparative study of physicians' decisions.
Little is known about physicians' triage decisions for patients with chest pain in the emergency department. We sought to understand better the variability and accuracy of physicians' triage decisions. ⋯ In simulated cases, physicians' triage decisions varied widely and their predictions of patient outcomes differed markedly from that of the validated prediction rule, suggesting that use of the prediction rule in the emergency department could improve physicians' decisions and patients' outcomes.
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Blockade of the renin-angiotensin system by angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers can cause hyperkalemia in patients with chronic renal insufficiency who are not on dialysis, but the risk of hyperkalemia in hemodialysis patients is unknown. ⋯ The use of ACE inhibitors or angiotensin receptor blockers is independently associated with an increased risk of developing hyperkalemia in chronic hemodialysis patients. The serum potassium concentration should be closely monitored when these medications are prescribed for hemodialysis patients.
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To examine the relation between follow-up office visits after emergency discharge and the risk of emergency readmissions in patients with asthma or chronic obstructive pulmonary disease (COPD). ⋯ Although these data should be interpreted with caution because of missing information on factors such as quality of care, they suggest that follow-up office visits are effective in reducing early relapses in patients who have been recently treated in emergency departments for asthma or COPD.