The American journal of medicine
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Observational Study
Not FIT for Use: Fecal Immunohistochemical Testing in the Inpatient and Emergency Settings.
Fecal immunochemical testing (FIT) is widely used for colorectal cancer screening, its only indication. Its effect on clinical decision-making beyond screening is unknown. We studied the use of FIT in emergency and inpatient settings and its impact on patient care. ⋯ Nearly all emergency department and inpatient FIT use was inappropriate. FIT resulted in more gastroenterology consultation but was not independently associated with inpatient endoscopy.
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Meta Analysis
Association Between Cinnamon Consumption and Risk of Cardiovascular Health: A Systematic Review and Meta-Analysis.
Cinnamon has been used as a traditional herbal medication for decades. Several studies have investigated cinnamon consumption and cardiovascular risk. So far, the evidence remains inconclusive. Thus, we aim to systematically review the currently available literature and quantify the evidence, if possible. ⋯ Our meta-analysis suggests that there is no association between cinnamon consumption and differences in LDL-c, HDL-c, and hemoglobin A1C levels. Further randomized control trials studies using a robust design with long-term cinnamon consumption are needed to further investigate any potential effect.
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Multicenter Study
Patient-Directed Discharges Among Persons Who Use Drugs Hospitalized with Invasive S. aureus Infections: Opportunities for Improvement.
Despite the high burden of Staphylococcus aureus infections among persons who use drugs, limited data exist comparing outcomes of patient-directed discharge (known as discharge against medical advice) compared with standard discharge among persons who use drugs hospitalized with S. aureus infection. ⋯ Among persons who use drugs hospitalized with invasive S. aureus infection, odds of hospital readmission for infection were almost 4-fold higher following patient-directed discharge compared with standard discharge. All-cause 1-year mortality was similarly high in both groups, and drug overdose was a common cause of death in patient-directed discharge group.
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Myocardial infarction with nonobstructive coronary arteries (MINOCA) remains an unresolved challenge. Many different diagnostic approaches are often required to diagnose, confirm, and evaluate MINOCA. The prevalence can be as high as 13% of all acute myocardial infarction patients, indicating that this condition is not rare. At this time, there have been no completed randomized clinical trials involving MINOCA patients, and a better understanding of the mechanisms and management of these patients is important. This exploratory analysis seeks to find possible etiologic factors, the value of novel biomarkers, and the effect of different treatment strategies in patients with MINOCA. ⋯ Because MINOCA is not a benign disease, the results of the current investigation could inform future diagnostic and therapeutic strategies and enhance the understanding of MINOCA patients.