Absence of left bundle branch block and blood urea nitrogen predict improvement in left ventricular ejection fraction in patients with cardiomyopathy and wearable cardioverter defibrillators.

Objective: To identify predictors of left ventricular ejection fraction (LVEF) improvement in patients with newly detected cardiomyopathy using wearable cardioverter defibrillators (WCDs).

Background: WCDs are useful in preventing sudden cardiac death in patients with reduced LVEF <35% while awaiting implantable cardioverter defibrillator (ICD) placement. In many patients, LVEF improves and an ICD is not indicated.

Is obstructive sleep apnea associated with ventricular tachycardia? A retrospective study from the National Inpatient Sample and a literature review on the pathogenesis of Obstructive Sleep Apnea.

Background: Obstructive sleep apnea (OSA) is a known independent risk factor for a multiple cardiovascular morbidities and mortality. The association of OSA and ventricular arrhythmias is less well understood. The aim of this analysis is to study the relationship between OSA and ventricular tachyarrhythmias.

Utilization of 4T score to determine the pretest probability of heparin-induced thrombocytopenia in a community hospital in upstate New York.

Background: Thrombocytopenia is common in hospitalized patients. Heparin-induced thrombocytopenia (HIT) is a life-threatening condition which can lead to extensive thrombosis. Diagnosis of HIT relies on clinical suspicion determined by 4T score and immunoassays through testing for anti-PF4/heparin antibodies.

How well do we need to control blood glucose before discharging DKA patients? A retrospective cohort study.

Purpose: To determine the ideal length of stay and glycemic control after resolution of acidosis in patients hospitalized for diabetic ketoacidosis, in order to reduce 30-day readmission. We hypothesized that both discharging patients within 24 hours of acidosis resolution and hyperglycemia at discharge are associated with higher probability of readmission.

Methods: We examined data from 208 consecutive patients hospitalized for diabetic ketoacidosis.

What's wrong with this artery? A medical disease discovered by a surgeon.

A 50-year-old man presenting with chest pain had positive stress echocardiography; and angiogram showed single artery coronary stenosis, presumed to be atherosclerotic. He was started on optimal medical therapy with good compliance. Four months later, he had a myocardial infarction (MI) and cardiac catheterisation surprisingly showed interval development of severe three-vessel stenosis.

The effect of statin therapy on allergic patients with asthma.

Background: 3-Hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors have significantly improved outcomes in coronary artery disease. They have anti-inflammatory and cholesterol-lowering effects. Statins alter the production of T(H)1 cytokines and thus promote a T(H)2 response.

Protein/creatinine ratio in preeclampsia: a systematic review.

Objective: To estimate the accuracy of the protein/creatinine ratio in predicting 300 mg of protein in 24-hour urine collection in pregnant patients with suspected preeclampsia.

Data Sources: Articles were identified through electronic databases (MEDLINE, CINHAL, and Cochrane) using the terms "preeclampsia," "protein/creatinine ratio," and "diagnosis," during the period January 1966 to October 2007. The relevant citations were hand searched.

DDAVP is effective in preventing and reversing inadvertent overcorrection of hyponatremia.

Background And Objectives: Adherence to therapeutic guidelines for the treatment of hyponatremia becomes difficult when water diuresis emerges during therapy. The objective of this study was to assess the effectiveness and safety of desmopressin acetate as a therapeutic agent to avoid overcorrection of hyponatremia and to lower the plasma sodium concentration again after inadvertent overcorrection.

Design, Setting, Participants, & Measurements: Retrospective chart review was conducted of all patients who were given desmopressin acetate during the treatment of hyponatremia during 6 yr in a 528-bed community teaching hospital.

Hypertonic saline for hyponatremia: risk of inadvertent overcorrection.

Background And Objectives: Data regarding dosage-response relationships for using hypertonic saline in treatment of hyponatremia are extremely limited. Objectives of this study were to assess adherence to previously published guidelines (limiting correction to <12 mEq/L per d and <18 mEq/L per 48 h) in treating hyponatremia with hypertonic saline and to determine the predictive accuracy of the Adrogué-Madias formula.

Design, Setting, Participants & Measurements: A retrospective review was conducted of all 62 adult, hyponatremic patients who were treated with hypertonic saline during 5 yr at a 528-bed, acute care, teaching hospital.

Testing a self-determination theory intervention for motivating tobacco cessation: supporting autonomy and competence in a clinical trial.

A longitudinal randomized trial tested the self-determination theory (SDT) intervention and process model of health behavior change for tobacco cessation (N = 1006). Adult smokers were recruited for a study of smokers' health and were assigned to intensive treatment or community care. Participants were relatively poor and undereducated.

Physician practices and attitudes regarding adult immunizations.

Objectives: To assess immunization practices and attitudes of U.S. primary care physicians regarding adult influenza and pneumococcal immunizations.

Self-determination, smoking, diet and health.

A Clinical Trial will test (1) a Self-Determination Theory (SDT) model of maintained smoking cessation and diet improvement, and (2) an SDT intervention, relative to usual care, for facilitating maintained behavior change and decreasing depressive symptoms for those who quit smoking. SDT is the only empirically derived theory which emphasizes patient autonomy and has a validated measure for each of its constructs, and this is the first trial to evaluate an SDT intervention. Adult smokers will be stratified for whether they are at National Cholesterol Education Program (1996) recommended goal for low-density lipoprotein cholesterol (LDL-C).