The American journal of medicine
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Restricting dietary sodium is a common recommendation given by clinicians to patients with heart failure and is one supported by current guidelines. However, the quality of evidence for this recommendation is suboptimal, and there is no consensus on the optimal level of sodium intake. ⋯ Nevertheless, sodium restriction is routinely recommended and remains a cornerstone of heart failure and blood pressure therapy. In this review we discuss the pros and cons of sodium restriction for patients with heart failure from the current literature.
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Meta Analysis
Predictors of Mortality in Myocardial Infarction and Nonobstructed Coronary Arteries: A Systematic Review and Meta-Regression.
The long-term mortality of patients with myocardial infarction and nonobstructed coronary arteries (MINOCA) remains poorly defined. This study aimed to determine the long-term mortality of patients with MINOCA and to identify potential prognostic determinants of long-term outcome. ⋯ The long-term mortality after MINOCA is lower than that in patients with myocardial infarction and obstructive coronary artery disease, but it is not trivial. Reduced ejection fraction, nonobstructive coronary artery disease, use of beta-blockers during follow up and ST depression on the admission electrocardiogram are significant predictors of long-term prognosis.
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Poor dietary quality is a leading contributor to mortality in the United States, and to most cardiovascular risk factors. By providing education on lifestyle changes and, specifically, dietary changes, hospitals have the opportunity to use the patient experience as a "teachable moment." The food options provided to inpatients and outpatients can be a paradigm for patients to follow upon discharge from the hospital. There are hospitals in the United States that are showcasing novel ways to increase awareness of optimal dietary patterns and can serve as a model for hospitals nationwide.
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Infectious endocarditis is a highly morbid disease with approximately 43,000 cases per year in the United States. The modified Duke Criteria have poor sensitivity; however, advances in diagnostic imaging provide new tools for clinicians to make what can be an elusive diagnosis. There are a number of risk stratification calculators that can help guide providers in medical and surgical management. ⋯ Recent studies suggest that oral and depo antibiotics may be viable alternatives to conventional intravenous therapy. Additionally, shorter courses of antibiotic therapy are potentially equally efficacious in patients who are surgically managed. Given the complexities involved with their care, patients with endocarditis are best managed by multidisciplinary teams.
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Review
Scientific Authors in a Changing World of Scholarly Communication: What Does the Future Hold?
Scholarly communication in science, technology, and medicine has been organized around journal-based scientific publishing for the past 350 years. Scientific publishing has unique business models and includes stakeholders with conflicting interests-publishers, funders, libraries, and scholars who create, curate, and consume the literature. ⋯ These rapidly evolving developments raise financial, legal, and ethical dilemmas that require solutions, while successful strategies are difficult to predict. Key challenges and trends are reviewed from the authors' perspective about how to engage the scholarly community in this multifaceted process.