Cardiovascular Disease and Migraine: Are the New Treatments Safe?

Purpose Of Review: The authors present data on cardiovascular safety for the new acute and preventive migraine treatments including ditans, gepants, and calcitonin gene-related peptide monoclonal antibodies (CGRP mAbs) alongside older medications like triptans and ergotamines.

Recent Findings: The authors conclude that there are no cardiovascular safety concerns for lasmiditan, and that it could be used in those with cardiovascular disease. In fact, the literature even suggests that triptans are safer in cardiovascular disease than their contraindications may suggest.

The importance of low-dose CT screening to identify emphysema in asymptomatic participants with and without a prior diagnosis of COPD.

Purpose: Chronic Obstructive Pulmonary Disease (COPD) includes chronic bronchitis, small airways disease, and emphysema. Diagnosis of COPD requires spirometric evidence and may be normal even when small airways disease or emphysema is present. Emphysema increases the risk of exacerbations, and is associated with all-cause mortality and increased risk of lung cancer.

Upregulation of cell surface GD3 ganglioside phenotype is associated with human melanoma brain metastasis.

Melanoma metastasis to the brain is one of the most frequent extracranial brain tumors. Cell surface gangliosides are elevated in melanoma metastasis; however, the metabolic regulatory mechanisms that govern these specific changes are poorly understood in melanoma particularly brain metastases (MBM) development. We found ganglioside GD3 levels significantly upregulated in MBM compared to lymph node metastasis (LNM) but not for other melanoma gangliosides.

Extracolonic findings and radiation at CT colonography: what the referring provider needs to know.

A better understanding of the risks and benefits of extracolonic findings and radiation dose will aid in the safe and proper implementation of CT colonography in clinical practice. The majority of extracolonic findings in screening patients are benign and can be ignored by referring physicians. Radiologists also need to be responsible in reporting extracolonic findings.

Congenital pulmonary airway malformation in a 36 year-old female.

Congenital pulmonary airway malformation (CPAM), previously known as congenital cystic adenomatoid malformation (CCAM), is an inborn abnormality of the lower respiratory system. Most often diagnosed in the perinatal period, these anomalies usually present with tachypnea, cyanosis, and respiratory distress. However, rare cases are asymptomatic and undiagnosed until adulthood.

Minimal impact of an electronic medical records system.

Background: Electronic medical records (EMRs) implementation in hospitals and emergency departments (EDs) is becoming increasingly more common. The purpose of this study was to determine the impact of an EMR system on patient-related factors that correlate to ED workflow efficiency.

Methods: A retrospective chart review assessed monthly census reports of all patients who registered and were treated to disposition during conversion from paper charts to an EMR system.

Screw size and insertion technique compared with removal rates for calcaneal displacement osteotomies.

Background: The calcaneal displacement osteotomy is frequently used by foot and ankle surgeons to correct hindfoot angular deformity. Headed compression screws are often used for this purpose, but a common complication is postoperative plantar heel pain from prominent hardware. We evaluated hardware removal rates after calcaneal displacement osteotomies and analyzed technical factors including screw size, position, and angle.

The effect of cerclage in twin gestations with short cervix: a Bayesian evaluation.

Objective: Bayesian inference allows the revision of prior clinical estimates of treatment effectiveness based on current data. We apply it to a published dataset evaluating the effect of cerclage upon preterm delivery in twin gestations with a short cervix.

Study Design: Prior probability distributions for delivery <35 weeks gestation for the control group and the treatment (cerclage) group were constructed under assumptions ranging from treatment having no effect (prior A) to halving early deliveries (prior C).

The nursing research idea fair: fostering research interest and activity among nurses.

Educators need creative means to enhance nurses' understanding of the research process. The Nursing Research Idea Fair provides a multifaceted educational experience to stimulate interest in research, educate nurses about research, and engage nurses in the research process in a fun, nonintimidating way. Nurse-driven research studies have increased fourfold since implementing the fair.

Outcomes analysis of daptomycin use in a community hospital.

This study was conducted to assess clinical and cost outcomes associated with the use of daptomycin. This objective was addressed through a consecutive patient chart review of the first 50 inpatients treated with daptomycin. Type of infection, identity of isolated pathogens, prior therapy, duration of therapy, length of hospitalization, cost of antibiotics, adverse events, and outcomes were evaluated.

Finger 'pebbles'. A dermatologic sign of diabetes mellitus.

A 35-year-old obese man presented with a chief complaint of hand dryness of 5 years' duration. He was a store manager and denied exposure to chemicals, repetitive trauma, chronic irritation, and hard manual labor. However, he did admit to frequent hand washing.

Methemoglobinemia: an unusual complication of topical anesthesia.

Allergic reactions tend to be easily recognized and treated, but methemoglobinemia is a rare, life-threatening complication of topical anesthesia of which our staff was unaware until recently. Team work prevented a patient fatality. Directives to alert the staff to suspect methemoglobinemia in patients who develop cyanosis and decreased oxygen saturation levels after administration of topical anesthesia despite administration of oxygen will prevent fatalities in the future.

Physician leaders see eye-to-eye.

Late in 1990, the American College of Physician Executives conducted a survey of hospital-based physician executives and chiefs of staff. Each was asked to judge the performance of the other in a wide range of activities. The results show a surprising degree of mutual regard and agreement.

Cholesterol measurements. Quality assurance and medical usefulness interrelationships.

This is a status report on cholesterol testing, using data from the College of American Pathologists Surveys program and Quality Assurance Service and the Lipid Research Clinics program. The clinical context for cholesterol testing is reviewed in order to develop a conceptual framework for analytic goals. Our analysis leads us to the following conclusions: First, the accuracy of cholesterol assays will be improved by using newly available reference material labeled by definitive methodology; this aspect of cholesterol testing is well monitored by proficiency testing.