The American journal of medicine
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Premature ventricular complexes/contractions (PVCs) are relatively common, occurring in 3%-20% of the general population, and are often found during work-up of palpitations or incidentally on routine electrocardiographic testing. They are usually considered benign but can be a sign of underlying cardiac disease and cause significantly impairing symptoms. While often thought of as a problem for the cardiologist, it is not uncommon for PVCs to be identified initially in a primary care or inpatient general medicine setting. This paper will review etiologies, epidemiology, evaluation, and management of PVCs for the internist.
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The placebo effect can be defined as any improvement of illnesses or reduction of subjective symptoms that result from interventions possessing no known physical effects. By contrast, the nocebo effect refers to undesirable symptoms or illnesses that follow interventions also lacking known physical effects. ⋯ Both placebo and nocebo effects can be potent and must be understood by both practitioners and researchers for proper application in clinical medicine. Individual caregivers can apply these principles to modify results in the daily care of patients.
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The relation of domestic physical activity with hypertension remains uncertain. We aimed to evaluate the prospective relation of domestic physical activity and new-onset hypertension among Chinese males and females. ⋯ Moderate domestic physical activity was associated with a lower risk of new-onset hypertension among both males and females.
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Handheld ultrasound devices are increasingly used by clinicians for their ease of use and portability. Their utility for estimating right atrial pressure (RAP) is poorly described. ⋯ Handheld ultrasonography is a useful tool that can accurately estimate RAP at the bedside.
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Bleeding remains a complication during dual antiplatelet therapy (DAPT) for acute coronary syndrome (ACS). Some data suggest a link between bleeding and worsened vascular outcomes. However, this association is unclear, due to omitting of minor bleedings when applying conservative scales. In contrast, the Platelet Inhibition and Outcomes (PLATO) trial classification used broad realistic capturing of all bleedings. ⋯ These large uniformly adjudicated data reveal that within 12 months of dual antiplatelet therapy, 1 out of 5 patients experiences bleeding. Overall, bleeding was associated with diminished incidence of death and MI but not strokes.