Disparities in the management of non-ST-segment elevation myocardial infarction in the United States.

Guidelines recommend managing patients aged ≥75 with non-ST-segment elevation myocardial infarction (NSTEMI) similar to younger patients. We analyze disparities in NSTEMI management and compare those ≥80 years to those <80 years. This is a matched case-control study using the 2016 National Inpatient Sample data of adults with NSTEMI receiving percutaneous coronary intervention with drug-eluting stent (PCI-DES) - one artery or no intervention.

Evolution of prescribing practices and outcomes in the COVID-19 pandemic in metropolitan areas.

Introduction: We wanted to characterize the evolution of the COVID-19 pandemic in a typical metropolitan area.

Methods: Data were extracted from the Detroit COVID-19 Consortium database for hospitalized COVID-19 patients treated in Southeast Michigan over the 12-month period from March 2020 to February 2021. Demographic and outcomes data were compared to CDC data.

Risk Factors in Hospitalized Patients for Heparin-Induced Thrombocytopenia by Real World Database: A New Role for Primary Hypercoagulable States.

Background: The aims of the study were to identify predictors of heparin-induced thrombocytopenia (HIT) in hospitalized adults, and to find additional factors associated with higher odds of HIT in primary hypercoagulable states.

Methods: A retrospective matched case-control study using discharge data from National Inpatient Sample database (2012 - 2014) was conducted. In primary outcome analysis, hospitalized patients with and without HIT were included as cases and controls, both matched for age and gender.

Mortality risk stratification helps identify patients with COVID-19 at risk of adverse outcomes.

Mortality risk stratification can identify patients with COVID-19 who are at higher risk of mortality, discharge to skilled nursing facility, and readmission, and may benefit from focused intervention strategies.

Mortality risk stratification can predict readmissions but not length of stay.

Objectives: To determine whether the mortality risk stratification (MORIS) strata can predict outcomes including mortality, readmission, and discharge disposition for specific diagnoses.

Study Design: Retrospective, observational study for hospitalized patients in 2016-2017 at an urban, medium-sized, community tertiary care hospital. All admitted patients with 1 of the following diagnoses were included in this study: acute myocardial infarction, chronic obstructive pulmonary disease, congestive heart failure, pneumonia, and sepsis.

Desirable Features of an Interdisciplinary Handoff.

Failure of communication of critical information during handoffs is one of the leading causes of medical errors, resulting in serious, yet preventable, adverse events in hospitals across the United States. Recent studies have shown that a majority of these errors occur during patient handoffs, with notable communication gaps in interdisciplinary handoffs. We suggest some features that would improve the handoff usability and effectiveness for interdisciplinary medical and nursing teams while potentially improving patient safety.

Nitrofurantoin: friend or foe?

Nitrofurantoin remains the gold standard treatment of uncomplicated cystitis as well as prophylactic treatment of recurrent urinary tract infections. Drug-induced hepatotoxicity presents in acute (3 in 1 000 000) and chronic (1 in 1500) forms. We present a patient with acute liver failure after 5 days of treatment.

Seizure Triggered by Sick Sinus Syndrome.

Sick sinus syndrome (SSS) is a dysfunction of sinoatrial node resulting in symptomatic bradycardia or sinus pauses causing decreased cardiac output with cerebral hypoperfusion and usually presents as syncope, presyncope or fatigue. The occurrence of a seizure is very rare. A 69-year-old man suffered two episodes of generalised tonic-clonic seizures.