Annals of internal medicine
-
Practice Guideline Guideline
Consensus recommendations for managing patients with nonvariceal upper gastrointestinal bleeding.
The management of patients with acute nonvariceal upper gastrointestinal bleeding has evolved substantially over the past 10 years amid a paucity of published consensus guidelines. ⋯ The efficacy of newer endoscopic therapeutic technologies, the optimal regimen of proton-pump inhibition, and the roles of other pharmacologic agents require further research.
-
The incidence of hepatocellular carcinoma was reported to be increasing in the United States. However, alternate explanations were diagnostic or reclassification bias and changes in the demographic features of the general population. ⋯ The incidence of hepatocellular carcinoma continues to increase rapidly in the United States, with rates increasing the fastest in white men 45 to 54 years of age. These findings are consistent with a true increase and could be explained by consequences of hepatitis C virus acquired during the 1960s and 1970s.
-
Review Comparative Study
Transcatheter closure versus medical therapy of patent foramen ovale and presumed paradoxical thromboemboli: a systematic review.
The optimal strategy to prevent recurrent presumed paradoxical emboli in patients with patent foramen ovale is unknown. ⋯ Transcatheter closure of patent foramen ovale may prevent a substantial proportion of cryptogenic strokes. Randomized clinical trials are needed.
-
Editorial Comment
Patent cardiac foramen ovale: stroke risk and closure.