Incidence of Hypotension Associated With Two Different Vasopressin Discontinuation Strategies in the Recovery Phase of Septic Shock.

Safe and effective vasopressor withdrawal strategies during the recovery phase of septic shock lack consensus and are not addressed in clinical practice guidelines. The purpose of this study was to compare the incidence of clinically relevant hypotension associated with different vasopressin (AVP) discontinuation strategies. This was a single-center, retrospective, cohort study, conducted at a university medical center over a three-year period.

Vancomycin with concomitant piperacillin/tazobactam vs. cefepime or meropenem associated acute kidney injury in the critically ill: A multicenter propensity score-matched study.

Purpose: The risk of acute kidney injury (AKI) associated with concomitant vancomycin and piperacillin/tazobactam in the intensive care unit (ICU) remains controversial. The aim of this study was to compare the AKI incidence associated with concomitant vancomycin and piperacillin/tazobactam compared to either cefepime or meropenem with vancomycin in the ICU.

Materials And Methods: A multicenter, retrospective, propensity score-matched cohort study was conducted in adult ICU patients administered vancomycin in combination with either piperacillin/tazobactam, cefepime, or meropenem were included.

Ecto-5'-Nucleotidase (CD73) Regulates the Survival of CD8+ T Cells.

Ecto-5'-nucleotidase (CD73) is an enzyme present on the surface of tumor cells whose primary described function is the production of extracellular adenosine. Due to the immunosuppressive properties of adenosine, CD73 is being investigated as a target for new antitumor therapies. We and others have described that CD73 is present at the surface of different CD8+ T cell subsets.

Chitosan-Based Delivery of Avian Reovirus Fusogenic Protein p10 Gene: and Studies towards a New Vaccine against Melanoma.

Reovirus is known to have an anticancer effect in both the preclinical and clinical assays. Current evidence suggests that the reovirus-mediated impact on tumor growth depends on the activation of specific antitumor immune responses. A feasible explanation for the oncolytic effects and immune system activation is through the expression of the fusogenic reovirus protein.

Effectiveness and safety of rivaroxaban vs. warfarin in patients with non-valvular atrial fibrillation and coronary or peripheral artery disease.

Aims: There are scarce data evaluating the effectiveness and safety of rivaroxaban vs. warfarin in non-valvular atrial fibrillation (NVAF) patients with concomitant coronary artery disease (CAD) and/or peripheral artery disease (PAD) treated in routine practice.

Methods And Results: Using MarketScan data from January 2012 to December 2017, we identified oral anticoagulant (OAC)-naïve NVAF patients receiving rivaroxaban (15-20 mg once daily) or warfarin, with comorbid CAD and/or PAD and ≥12 months of insurance coverage before OAC initiation.

Comparative Effectiveness of Analgesics to Reduce Acute Pain in the Prehospital Setting.

: The objectives of this study were to assess comparative effectiveness and harms of opioid and nonopioid analgesics for the treatment of moderate to severe acute pain in the prehospital setting. : We searched MEDLINE, Embase, and Cochrane Central from the earliest date through May 9, 2019. Two investigators screened abstracts, reviewed full-text files, abstracted data, and assessed study level risk of bias.

Adverse Effects of Pharmacologic Treatments of Major Depression in Older Adults.

Objectives: To assess adverse effects of pharmacologic antidepressants for treatment of major depressive disorder (MDD) in adults 65 years of age or older.

Design: Systematic review and meta-analysis.

Setting: Specialist or generalist outpatient setting, rehabilitation facility, and nursing facilities.

Systematic review and meta-analysis of catheter ablation of ventricular tachycardia in ischemic heart disease.

Background: Patients with ischemic heart disease (IHD) are at risk for ventricular tachycardia (VT). Catheter ablation (CA) may reduce this risk.

Objective: To perform a systematic review and meta-analysis of randomized controlled trials (RCTs) of CA of VT in patients with IHD.

Effectiveness and safety of rivaroxaban vs. warfarin in patients with non-valvular atrial fibrillation and heart failure.

Aims: Heart failure (HF) is a common co-morbidity in non-valvular atrial fibrillation (NVAF) patients and a potent risk factor for stroke, bleeding, and a decreased time-in-therapeutic range with warfarin. We assessed the real-world effectiveness and safety of rivaroxaban and warfarin in NVAF patients with co-morbid HF.

Methods And Results: Using US Truven MarketScan Commercial and Medicare supplemental database claims data from 11/2011 to 12/2016, we identified oral anticoagulant (OAC)-naïve NVAF patients with HF (International Classification of Diseases, 10th Revision codes of I50 or I09.

Effectiveness and Safety of Apixaban, Dabigatran, and Rivaroxaban Versus Warfarin in Frail Patients With Nonvalvular Atrial Fibrillation.

Background: Frailty predicts poorer outcomes and decreased anticoagulation use in patients with nonvalvular atrial fibrillation. We sought to assess the effectiveness and safety of apixaban, dabigatran and rivaroxaban versus warfarin in frail nonvalvular atrial fibrillation patients.

Methods And Results: Using US MarketScan claims data from November 2011 to December 2016, we identified frail oral anticoagulant-naïve nonvalvular atrial fibrillation patients with ≥12 months of continuous insurance coverage before oral anticoagulant initiation.

Systematic Review and Meta-Analysis of Real-World Studies Evaluating Rivaroxaban for Cancer-Associated Venous Thrombosis.

Introduction: While not designated as guideline-recommended first-line anticoagulation therapy, about one in five patients in the United States receive rivaroxaban for the treatment of cancer-associated venous thrombosis (CAT).

Methods: A systematic review and meta-analysis were performed to evaluate the incidences of recurrent venous thromboembolism (VTE), major bleeding, and all-cause mortality in rivaroxaban patients treated for CAT in routine practice. Literature searches of MEDLINE and SCOPUS were performed through September 2017 to identify real-world studies of ≥ 20 patients evaluating the incidence of recurrent VTE, major bleeding, or all-cause mortality in CAT patients anticoagulated with rivaroxaban.

The Emerging Role of Inflammation in Cardiovascular Disease.

Objective: To review the role of inflammatory suppression in patients with atherosclerotic cardiovascular disease (ASCVD) with a focus on the interleukin-1β blocker canakinumab.

Data Sources: An Ovid MEDLINE literature search (1946 to February 2018) was performed using search terms inflammation, ASCVD, atherosclerosis, C-reactive protein, canakinumab. Additional references were identified from a review of literature citations.

Meta-Analysis of Time in Therapeutic Range in Continuous-Flow Left Ventricular Assist Device Patients Receiving Warfarin.

Continuous-flow left ventricular assist devices (CF-LVADs) prolong survival in advanced heart failure patients. Anticoagulation control is critical in CF-LVAD patients due to increased thromboembolic and bleeding risk. We assessed the quality of INR control in CF-LVAD patients measured by time in therapeutic range (TTR).

Anticoagulant Bridge Comparison in Mechanical Circulatory Support Patients.

Maintaining mechanical circulatory support (MCS) device patients in a specified therapeutic range for anticoagulation remains challenging. Subtherapeutic international normalized ratios (INRs) occur frequently while on warfarin therapy. An effective anticoagulant bridge strategy may improve the care of these patients.

Non-modifiable determinants of pharmacy residency match rates.

Objective: The purpose of this study was to examine non-modifiable pharmacy program characteristics on residency match rates.

Methods: American Society of Health-System Pharmacists match and non-match lists were de-identified and evaluated for students graduating in 2015. Variables analysed included length of program, type of institution and didactic grading scheme.

Exceptional Outgroup Stereotypes and White Racial Inequality Attitudes toward Asian Americans.

Stereotypes of outgroups help create social identificational boundaries for ingroups. When the ingroup is dominant, members employ individualist sentiments to justify their status. In this study, we build on advances in social psychological research that account for multiple outgroup stereotypes.

Impact of pre-implant amiodarone exposure on outcomes in cardiac transplant recipients.

Amiodarone remains one of the preferred antiarrhythmic medications for patients with advanced heart failure awaiting cardiac transplant. However, the long half-life and rapid redistribution of this agent into donor myocardium expose heart transplant recipients to potential adverse outcomes. In reviewing the current body of literature, we found that pre-operative amiodarone exposure can increase the risk of bradycardia post-transplant; however, this is unlikely to require permanent pacemaker implant.

Occupational conditions, self-care, and obesity among clergy in the United States.

Prior research has shown that a variety of occupational conditions such as long work hours are associated with increased likelihood of obesity. In this study, we use the specific case of the clergy to explore how occupational conditions are linked to increased or decreased odds of being obese. We hypothesize that stressful conditions are associated with increased odds of obesity and that self-care practices are associated with decreased odds.

Neighborhood Ethnic Composition and Problem Drinking Among Older Mexican American Men: Results from the Hispanic Established Populations for the Epidemiologic Study of the Elderly.

Ethnic enclaves may be protective for health. This study investigates the effects of neighborhood co-ethnic density on problem drinking among older Mexican American men. Probability sample of 2,086 community-dwelling Mexican Americans aged 75 or older drawn in 2004-2005 residing in communities in Arizona, California, Colorado, New Mexico and Texas.

Tract seeding following radiofrequency ablation for hepatocellular carcinoma: prevention, detection, and management.

Radiofrequency ablation (RFA) has become an important tool in the armamentarium of interventional oncology, particularly in the treatment of primary hepatocellular carcinoma and metastatic tumors. This procedure has proven to be an effective adjunct in treating hepatic tumors as a bridge to liver transplantation, and has a low complication profile. Although adverse events are rare and usually minor, a notable negative outcome is dissemination and implantation of viable tumor cells into the route of applicator entry, or tract seeding.

Microwave lung ablation complicated by bronchocutaneous fistula: case report and literature review.

Microwave ablation is a developing treatment option for unresectable lung cancer. Early experience suggests that it may have advantages over radiofrequency (RF) ablation with larger ablation zones, shorter heating times, less susceptibility to heat sink, effectiveness in charred lung, synergism with multiple applicators, no need for grounding pads, and similar survival benefit. Newer microwave ablation devices are being developed and as their use becomes more prevalent, a greater understanding of device limitations and complications are important.