Restrictive Versus Liberal Transfusion in Symptomatic Coronary Artery Disease and Myocardial Infarction: A Meta-Analysis of Randomized Controlled Trials.

Background: In patients with coronary artery disease (CAD) and/or myocardial infarction (MI), anemia is associated with an increased risk of adverse cardiovascular (CV) outcomes. Transfusion goals in such patients remain unclear.

Study Question: A meta-analysis of the available randomized controlled trials (RCTs) was conducted comparing restrictive and liberal transfusion strategies in patients with symptomatic CAD/MI.

Invasive Versus Conservative Strategy in Older Adults ≥75 Years of Age With Non-ST-segment-Elevation Acute Coronary Syndrome: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Background: Older adults with non-ST-segment-elevation acute coronary syndrome are less likely to undergo an invasive strategy compared with younger patients. Randomized controlled trials traditionally exclude older adults because of their high burden of geriatric conditions.

Methods And Results: We searched for randomized controlled trials comparing invasive versus medical management or a selective invasive (conservative) strategy for older patients (age≥75 years) with non-ST-segment-elevation acute coronary syndrome.

Fostering change, empowering faculty: comments on the NURSLITT study and the five-year rule.

The five-year rule must die. Despite an extensive literature search, the origins of the five-year rule remain unknown. In an era when the nursing profession is so focused on evidence-based practice, any approach that arbitrarily limits literature searches to articles published in the previous five years lacks scientific basis.

P2Y12 Inhibitor Monotherapy After Short-Term Dual Antiplatelet Therapy in Acute Coronary Syndrome.

Recent studies have shown similar safety and efficacy of short-term dual antiplatelet therapy (DAPT) followed by P2Y12 inhibitor (P2Y12i) monotherapy when compared with standard DAPT. However, the optimal DAPT duration and regimen in acute coronary syndrome (ACS) patients who underwent percutaneous coronary intervention is still unclear. Online databases were searched for randomized controlled trials evaluating P2Y12i monotherapy after short DAPT (≤3 months) versus standard DAPT (≥12 months) in ACS patients.

Cardiovascular Outcomes With Empagliflozin and Dapagliflozin in Patients Without Diabetes.

Although the cardiovascular (CV) benefits of sodium-glucose cotransporter-2 inhibitors (SGLT2i) in patients with diabetes mellitus (DM) are well known, their effects in patients without DM continue to be explored. We provide a meta-analysis of the available evidence. Online databases were searched for randomized controlled trials (RCTs) comparing SGLT2i to placebo/control in patients without DM.

A Multifunctional, Low Cost and Sustainable Neonatal Database System.

Continuous improvement in the clinical performance of neonatal intensive care units (NICU) depends on the use of locally relevant, reliable data. However, neonatal databases with these characteristics are typically unavailable in NICUs using paper-based records, while in those using electronic records, the inaccuracy of data and the inability to customize commercial data systems limit their usability for quality improvement or research purposes. We describe the characteristics and uses of a simple, neonatologist-centered data system that has been successfully maintained for 30 years, with minimal resources and serving multiple purposes, including quality improvement, administrative, research support and educational functions.

Safety and efficacy of glucagon-like peptide-1 receptor agonists on cardiovascular events in overweight or obese non-diabetic patients.

Background: Randomized controlled trials (RCTs) have shown variable cardiovascular (CV) outcomes in overweight or obese patients without diabetes mellitus (DM) who are treated with glucagon-like peptide-1 receptor agonists (GLP-1 RAs) vs. placebo. We conducted a meta-analysis of the available studies.

Meta-analysis of immediate complete vs staged complete revascularization in patients with acute coronary syndrome and multivessel disease.

Background: Randomized controlled trials (RCTs) have shown varying results between immediate and staged complete percutaneous coronary intervention (PCI) in patients with acute coronary syndrome (ACS) and multivessel disease (MVD). We conducted a meta-analysis to reconcile the findings.

Methods: Online databases were searched for RCTs comparing immediate vs staged complete PCI in patients presenting with ACS.

Exploring the Use of Common Strict Search Criteria in Nursing Literature Searches.

Background: Health sciences librarians and nursing journal contributors have expressed concern about the impact of using strict parameters when searching the literature.

Purpose: The purpose of this study was to explore the use of strict search criteria (eg, 5-year rule, "nurse as author") by direct care nurses and nursing students.

Methods: Fourteen online focus groups were conducted with 54 participants: direct care nurses, health sciences librarians, nursing faculty, and nursing students.

Short-term dual antiplatelet therapy for 1-3 months after percutaneous coronary intervention using drug eluting stents: A systematic review and meta-analysis of randomized clinical trials.

Background: The optimal dual antiplatelet therapy (DAPT) duration and regimen in patients undergoing percutaneous coronary intervention (PCI) using current generation drug eluting stents (DES) is still unclear.

Aims: To compare the safety and efficacy of short-term DAPT (S-DAPT) with longer duration DAPT (l-DAPT) after contemporary PCI.

Methods: We searched for studies comparing S-DAPT (≤3 months) followed by single antiplatelet therapy (SAPT) with aspirin or a P2Y inhibitor against L-DAPT (6-12 months) after PCI with current generation DES.

Differential diagnosis and management of immune checkpoint inhibitor-induced colitis: A comprehensive review.

Immune checkpoint inhibitors (ICIs) are a new class of cancer pharmacotherapy consisting of antibodies that block inhibitory immune regulators such as cytotoxic T lymphocyte antigen 4, programmed cell death 1 and programmed death-ligand 1. Checkpoint blockade by ICIs reactivates a tumor-specific T cell response. Immune-related adverse events can occur in various organs including skin, liver, and gastrointestinal tract.

Aberrant expression of SATB2, CDX2, CDH17 and CK20 in hepatocellular carcinoma: a pathological, clinical and outcome study.

Aims: Data regarding expression of intestinal markers in hepatocellular carcinoma (HCC) are limited. We determined the clinicopathological associations of cytokeratin (CK)19, a progenitor liver epithelial cell marker as well as biliary epithelial marker, and intestinal immunohistochemical markers expression in HCC and assessed their prognostic value.

Methods And Results: Tissue sections and/or tissue microarrays (TMAs) from 202 known HCCs were immunostained using CK19, CK20, CDH17, CDX2 and SATB2 antibodies.

Utility of the READMIT Index to Identify Community Hospital 30-Day Psychiatric Readmissions.

This case-controlled study determined the utility of the READMIT index to identify the risk for 30-day readmission of patients discharged from an urban community hospital psychiatric inpatient unit. Data was collected from 118 matched patient pairs from 2017 to 2018. Findings demonstrated the READMIT index did not effectively discriminate those patients who were likely to readmit within 30 days.

New-onset seizure activity in a transplant patient on immunosuppressive therapy.

The evaluation of new-onset seizure activity must raise a much broader differential than just epilepsy. This case study highlights that broad differential and identifies an important, but less common, cause of seizure activity in specific patient populations. Information is summarized from recent primary research, case series, literature reviews, and meta-analyses.

Predictors of Perceived Educational Value in Emergency Medicine Residency Simulation Cases.

Objectives: This study was designed to identify characteristics associated with the perceived educational value of simulation cases in an emergency medicine residency curriculum.

Methods: Following 17 individual emergency medicine simulation cases, a standard feedback questionnaire was completed by emergency medicine residents. Multiple linear regression was performed to identify significant variables that predict perceived educational value.

Trauma Management of the Pregnant Patient.

Trauma continues to be a leading cause of nonobstetric maternal and fetal mortality worldwide. Caring for the pregnant trauma patient requires a systematic and multidisciplinary approach. It is important to understand the anatomic and physiologic changes that occur during pregnancy.

Respiratory Failure and Mechanical Ventilation in the Pregnant Patient.

Fewer than 2% of all peripartal patients need intensive care unit admission. But due to some anatomic and physiologic changes in pregnancy, respiratory failure can be promoted. This article reviews several obstetric and nonobstetric diseases that lead to respiratory failure and the treatment of these.

Family medicine residents remain unaware of hospital charges for diagnostic testing.

Background And Objectives: The Accreditation Council for Graduate Medical Education (ACGME) has mandated that resident training programs incorporate instruction on the economic reality of health care. Studies over the past 15 years have demonstrated that resident physicians, as well as physicians in practice, are unaware of the charges associated with commonly ordered diagnostic tests. The last study to document family medicine residents' knowledge of the hospital charges associated with diagnostic studies was published over 10 years ago.

Histoplasmosis complicating tumor necrosis factor-α blocker therapy: a retrospective analysis of 98 cases.

Background: Histoplasmosis may complicate tumor necrosis factor (TNF)-α blocker therapy. Published case series provide limited guidance on disease management. We sought to determine the need for long-term antifungal therapy and the safety of resuming TNF-α blocker therapy after successful treatment of histoplasmosis.