The Permanente journal
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The Permanente journal · Jan 2019
Case ReportsAcute Influenza Infection Presenting with Cardiac Tamponade: A Case Report and Review of Literature.
Cardiac complications associated with influenza infection can occur either via a direct effect of the virus on the heart or through exacerbation of preexisting cardiovascular disease. We present a case of a 57-year-old man with acute influenza infection complicated by pericardial effusion and cardiac tamponade. ⋯ Pericardial involvement is a rare and perhaps underreported complication of influenza infection. Early recognition of cardiac symptoms and appropriate diagnostic workup in a patient presenting with influenza-like symptoms is important to avoid life-threatening complications.
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The Permanente journal · Jan 2019
Resident and Faculty Perspectives on Prevention of Resident Burnout: A Focus Group Study.
The high prevalence and negative implications of resident physicians' burnout is well documented, yet few effective interventions have been identified. ⋯ We engaged residents and core faculty across specialties in the identification of factors contributing to burnout and possible targets for interventions. Our results highlight potential focus areas for future burnout interventions and point to the importance of interventions targeted at the social environments in which residents' work and learn.
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Total thyroidectomy has been shown to provide a cost-effective and efficient method of permanently treating Graves disease; however, hypocalcemia can be a common complication. ⋯ Patients with Graves disease are about twice as likely to experience hypocalcemia or clinically severe hypocalcemia postoperatively than are patients without the disease.
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The Permanente journal · Jan 2019
Cocaine Positivity in ST-Elevation Myocardial Infarction: A True or False Association.
Every year, more than 500,000 US Emergency Department visits are associated with cocaine use. People who use cocaine tend to have a lower incidence of true ST-elevation myocardial infarction (STEMI). ⋯ Among those with suspected STEMI, patients with CPos findings had a higher incidence of false STEMI. Older age, lack of health insurance, and troponin levels outside of defined limits were associated with true STEMI in this group.