The American journal of medicine
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Review
Obstructive sleep apnea: a new preventive and therapeutic target for stroke: a new kid on the block.
Stroke is the second leading cause of death worldwide and a major cause of mental and physical impairment. Numerous studies have identified risk factors for stroke, including hypertension, atrial fibrillation, diabetes, and smoking. However, even after considering these well-recognized risk factors, there is substantial variation in stroke rates and stroke-related outcomes. ⋯ Early recognition and treatment of obstructive sleep apnea during the post-stroke period lead to better neurologic outcome. Healthcare providers should be aware of the strong association of obstructive sleep apnea as a risk factor for stroke and its effect on neurologic recovery. The presence of hypertension and diabetes-the 2 most common comorbid conditions in obstructive sleep apnea-should prompt diagnostic workup for and treatment of obstructive sleep apnea as a way of primary and secondary prevention of stroke.
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Cryofibrinogenemia is frequently associated with cryoglobulinemia. The aim of this study was to determine the characteristics associated with the presence of cryofibrinogenemia in patients with cryoglobulinemic vasculitis. ⋯ Our results strongly suggest that presence of cryofibrinogenemia is associated with a more severe phenotype among patients with cryoglobulinemic vasculitis.
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Review Meta Analysis Comparative Study
Predictive Value of Computed Tomography in Acute Pulmonary Embolism: Systematic Review and Meta-analysis.
Many computed tomography (CT) parameters have been proposed as potential predictors of outcome in acute pulmonary embolism. We sought to summarize available evidence on the predictive value of CT severity parameters for short-term clinical outcome in pulmonary embolism. ⋯ Across all end points, the RV/LV diameter ratio on transverse CT sections has the strongest predictive value and most robust evidence base for adverse clinical outcomes in patients with acute pulmonary embolism.
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As residency programs move toward measuring milestones for competency-based education assessment, medical schools will need to collaborate with residencies to determine competencies for graduating students. The objective of this study is to define the educational milestones for fourth-year medical students during an Internal Medicine sub-internship. ⋯ Tasks in the reporter domain such as taking a history, collecting medical records, and reporting results can be characterized as medical student milestones.
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Although common, little is known about factors associated with peripherally inserted central catheter-related deep vein thrombosis (PICC-DVT). To better guide clinicians, we performed a comprehensive literature review to summarize best practices for this condition. ⋯ PICC-DVT is common, costly and morbid. Available evidence provides guidance for diagnosis, treatment and prevention of this condition.