Clinical Characteristics and Prevalence of Atrial High-Rate Episodes in Patients With Cardiac Implantable Electronic Devices.

Background Atrial high-rate episodes (AHREs) detected by cardiac implantable electronic devices (CIEDs) are indicative of future clinical atrial fibrillation (AF) and stroke risk. This study aimed to investigate the prevalence of AHREs among Thai patients with CIED implantation and identify associated risk factors. Methods A retrospective observational study enrolled 278 CIED patients with AHREs lasting five minutes to 24 hours, with an average atrial rate ≥ 175 bpm, excluding known clinical AF at device implantation.

Leadless pacemaker implantation in challenging scenarios: A case report series of patients with mechanical tricuspid valves.

Introduction: The advancement of medical technology has introduced leadless pacemakers (LPMs) as a significant innovation in cardiac pacing, offering potential advantages over traditional ventricular transvenous pacemakers. This report explores the application of LPMs in two patients with complex valvular histories, particularly those with mechanical tricuspid valves.

Case Reports: The first case involves a 60-year-old male with a history of rheumatic heart disease and triple valve replacement who developed a high-grade AV block.

Adjustable Phonatory PEEP to Treat Dysphonia: A Preliminary Investigation of Progressive Masked Voice Exercises (PMVE).

The Progressive Masked Voice Exercises (PMVE) with an innovative semioccluded ventilation mask fitted and adjustable positive end-expiratory pressure (PEEP) valve was evaluated. This study aimed to compare the effectiveness of the PMVE with the PEEP device and the Vocal Function Exercise (VFE) program on acoustic, auditory-perceptual, aerodynamic, and self-report measures. Twenty-five participants diagnosed with voice disorders met the criteria.

Dementia risk reduction between DOACs and VKAs in AF: A systematic review and meta-analysis.

Introduction: Direct oral anticoagulants (DOACs) become the recommended treatment over vitamin K antagonists (VKA) in patients with non-valvular atrial fibrillation (AF). However, their effectiveness in reducing cognitive impairment and dementia compared to VKA remains unclear.

Methods: A systematic literature search was conducted on Ovid MEDLINE, EMBASE, and Cochrane Database.

Premature Ventricular Contraction-Induced Cardiomyopathy: Contemporary Evidence from Risk Stratification, Pathophysiology, and Management.

Premature ventricular complexes (PVCs) are commonly encountered problems in clinical settings. The range of symptoms can be from asymptomatic to palpitations, fatigue, or heart failure symptoms. A higher burden of PVCs is a risk factor for development of PVC-induced cardiomyopathy (PIC).

The burden of alcohol-related cardiovascular complications in young and middle-aged adults: rising burden of atrial fibrillation and hypertensive heart disease.

Background And Aims: The burden of alcohol-related complications is high and rising. However, there are notable deficiencies in comprehensive epidemiological study focusing on cardiovascular complications from alcohol, especially among young and middle-aged adults. We thus aimed to determine the burden of these conditions in young and middle-aged adults globally.

Real-World Effectiveness of Intravenous and Oral Antibiotic Stepdown Strategies for Gram-Negative Complicated Urinary Tract Infection With Bacteremia.

Background: Robust data are lacking regarding the optimal route, duration, and antibiotic choice for gram-negative bloodstream infection from a complicated urinary tract infection source (GN-BSI/cUTI).

Methods: In this multicenter observational cohort study, we simulated a 4-arm registry trial using a causal inference method to compare effectiveness of the following regimens for GN-BSI/cUTI: complete course of an intravenous β-lactam (IVBL) or oral stepdown therapy within 7 days using fluoroquinolones (FQs), trimethoprim-sulfamethoxazole (TMP-SMX), or high-bioavailability β-lactams (HBBLs). Adults treated between January 2016 and December 2022 for or species GN-BSI/cUTI were included.

High vs low CPAP strategy with aerosolized calfactant in preterm infants with respiratory distress syndrome.

Background: Optimal CPAP strategy to prevent CPAP failure defined as need for endotracheal intubation is unknown.

Objective: To evaluate the risk of CPAP failure in infants treated with high vs low CPAP strategy while receiving aerosolized calfactant in the AERO-02 clinical trial and AERO-03 expanded access program.

Methods: Infants born between 29 0/7 to 36 6/7 weeks were included.

Oral β-Lactams, Fluoroquinolones, or Trimethoprim-Sulfamethoxazole for Definitive Treatment of Uncomplicated or Species Bacteremia From a Urinary Tract Source.

Background: Fluoroquinolones (FQs) are effective for oral step-down therapy for gram-negative bloodstream infections but are associated with unfavorable toxic effects. Robust data are lacking for trimethoprim-sulfamethoxazole (TMP-SMX) and high-bioavailability β-lactams (HBBLs).

Methods: In this multicenter observational cohort study, we simulated a 3-arm registry trial using causal inference methods to compare the effectiveness of FQs, TMP-SMX, or HBBLs for gram-negative bloodstream infections oral step-down therapy.

Antibiotic prescribing for adults with group A streptococcal bacteremia in a large healthcare system.

Purpose: Limited data exist regarding treatment of invasive group A streptococcal (GAS) infections, including safety and efficacy of oral (PO) step-down therapy. We sought to describe current prescribing practices and clinical outcomes for patients with GAS bacteremia across a large health system, including a prespecified subset of patients who stepped down to PO antibiotics.

Methods: This retrospective cohort study included adult patients with a positive blood culture for GAS between July 2018 and July 2021.

Pathways to lung cancer diagnosis among individuals who did not receive lung cancer screening: a qualitative study.

Background: Although early detection of lung cancer through screening is associated with better prognosis, most lung cancers are diagnosed among unscreened individuals. We therefore sought to characterize pathways to lung cancer diagnosis among unscreened individuals.

Methods: Participants were individuals with lung cancer who did not undergo asymptomatic lung cancer screening (n = 13) and healthcare providers who may be involved in the pathway to lung cancer diagnosis (n = 13).

Subcutaneous Insulin Versus Traditional Intravenous Insulin Infusion in Treatment of Mild to Moderate Diabetic Ketoacidosis.

Background: Intravenous (IV) insulin infusions are the current standard of care for treatment of diabetic ketoacidosis (DKA). Subcutaneous (SQ) insulin, however, may also be a safe and effective alternative.

Objective: The purpose of this study was to compare patient-centered outcomes related to the treatment of mild to moderate DKA using two different protocols: an SQ insulin protocol and an IV insulin infusion protocol with an initial bolus (IVB) or without a bolus (IVNB).

Cord blood sampling for neonatal admission laboratory testing-An evidence-based blood conservation strategy.

Historically, blood for admission laboratory studies in neonates was obtained through direct neonatal phlebotomy. Over the past decade there has been an increase in studies evaluating the validity and clinical impact of using a cord blood sample for many admission laboratory studies. This article reviews various studies that together have shown that using cord blood samples for admission testing in neonates is both acceptable and beneficial.

Impact of a Multifaceted Intervention on Antibiotic Prescribing for Cystitis and Asymptomatic Bacteriuria in 23 Community Hospital Emergency Departments.

Urinary tract infections (UTIs) are over-diagnosed and over-treated in the emergency department (ED) leading to unnecessary antibiotic exposure and avoidable side effects. However, data describing effective large-scale antimicrobial stewardship program (ASP) interventions to improve UTI and asymptomatic bacteriuria (ASB) management in the ED are lacking. We implemented a multifaceted intervention across 23 community hospital EDs in Utah and Idaho consisting of in-person education for ED prescribers, updated electronic order sets, and implementation/dissemination of UTI guidelines for our healthcare system.

Glyphosate exposure and preterm birth: A nested case-control pilot study.

Preterm birth (PTB) is associated with a high risk of infant mortality and long-term adverse health effects. Glyphosate is a broad-spectrum herbicide applied in agricultural and non-agricultural settings. Studies suggested an association between maternal exposure to glyphosate and PTB among mostly racially homogenous populations, though results were inconsistent.

Perinatal Hemolytic Disorders and Identification Using End Tidal Breath Carbon Monoxide.

Hemolytic disorders can cause severe morbidity or can be life-threatening. Before the recent development of practical and inexpensive testing for hemolysis by quantifying carbon monoxide in end-tidal breath, some hemolytic disorders in perinatal patients were not detected until severely problematic hyperbilirubinemia and/or anemia occurred. Here we review studies aimed at establishing the normal reference intervals for end tidal breath carbon monoxide (ETCO) in various perinatal populations.

Nucleated Red Blood Cell Emergence-Time in Newborn Lambs Following a Dose of Darbepoetin Alfa.

Background: Nucleated red blood cells (NRBC) are very uncommon in the blood of children and adults, but small numbers are not rare in neonates on the day of birth. Elevated NRBC counts in neonates can be seen following erythropoietin dosing. Limited studies in human neonates suggest the time-interval between erythropoietin dosing and the first appearance of NRBC in the blood (the "NRBC emergence-time") is in excess of 24 hours.

The Attending of the Day ("The Pretending"): An Exercise in Autonomy.

Background As regulations governing appropriate resident supervision increase, it has become increasingly difficult to provide residents with the appropriate level of autonomy during their training years. The "Attending of the Day" describes an experiential teaching method that provides a balance between learners' autonomy and appropriate supervision. Methodology Each day one member of the inpatient team is selected as the "Attending of the Day," or "The Pretending.

Considerations for development of pharmacy support models for COVID-19 alternate care sites.

Purpose: Guidance on alternate care site planning based on the experience of a health-system pharmacy department in preparing for an expected surge in coronavirus disease 2019 (COVID-19) cases is provided.

Summary: In disaster response situations such as the COVID-19 pandemic, healthcare institutions may be compelled to transition to a contingency care model in which staffing and supply levels are no longer consistent with daily practice norms and, while usual patient care practices are maintained, establishment of alternate care sites (eg, a convention center) may be necessitated by high patient volumes. Available resources to assist hospitals and health systems in alternate care site planning include online guidance posted within the COVID-19 resources section of the US Army Corps of Engineers website, which provides recommended medication and supply lists; and the Federal Healthcare Resilience Task Force's alternate care site toolkit, a comprehensive resource for all aspects of alternate care site planning, including pharmacy services.

American Pharmacists Attitudes and Behaviors Regarding Medication Error Disclosure.

Background: Patient safety places emphasis on full disclosure, transparency, and a commitment to prevent future errors. Studies addressing the disclosure of medication errors in the profession of pharmacy are lacking.

Objective: This study examined attitudes and behaviors of American pharmacists regarding medication errors and their disclosure to patients.

Cognitive control in obsessive-compulsive disorder (OCD): Proactive control adjustments or consistent performance?

Cognitive control is often parsed into proactive and reactive control components. In proactive control, task- and goal-relevant information is utilized in a top-down manner to improve performance, while reactive control is a late-response corrective mechanism that occurs after conflict or errors. We tested whether people with obsessive-compulsive disorder (OCD) would show specific proactive control dysfunction in 31 individuals with OCD and 30 psychiatrically-healthy controls.