The American journal of medicine
-
Multicenter Study Comparative Study
Acute aortic dissection in blacks: insights from the International Registry of Acute Aortic Dissection.
-
Several common misconceptions can make the clinical diagnosis of subacute pericardial tamponade challenging. Widely known physical findings of pericardial tamponade lack sensitivity and specificity. ⋯ Over-reliance on echocardiography may result in over-utilization of pericardial drainage procedures. Awareness of these misconceptions with an integrative approach to both clinical and imaging data will help clinicians to assess the hemodynamic impact of pericardial effusion and the need for drainage.
-
A variety of claims about possible associations between gun ownership rates, mental illness burden, and the risk of firearm-related deaths have been put forward. However, systematic data on this issue among various countries remain scant. Our objective was to assess whether the popular notion "guns make a nation safer" has any merits. ⋯ The number of guns per capita per country was a strong and independent predictor of firearm-related death in a given country, whereas the predictive power of the mental illness burden was of borderline significance in a multivariable model. Regardless of exact cause and effect, however, the current study debunks the widely quoted hypothesis that guns make a nation safer.
-
Randomized Controlled Trial Comparative Study
Rate-control versus rhythm-control strategies and outcomes in septuagenarians with atrial fibrillation.
The prevalence of atrial fibrillation substantially increases after 70 years of age. However, the effect of rate-control versus rhythm-control strategies on outcomes in these patients remains unclear. ⋯ In septuagenarian patients with atrial fibrillation, compared with rhythm-control, a rate-control strategy was associated with significantly lower mortality and hospitalization.
-
Multicenter Study
Primacy of the 3B approach to control risk factors for cardiovascular disease in type 2 diabetes patients.
Individually, diabetes mellitus, hypertension, and dyslipidemia have been shown to increase the risk of cardiovascular disease. While traditional management of Type 2 diabetes has focused mainly on glycemic control, robust evidence supports the integration of hypertension and dyslipidemia management to reduce the risk of cardiovascular disease. The primary objective of this study was to assess the level of control of blood glucose, blood pressure, and blood lipids (3Bs) among patients with type 2 diabetes. An additional objective was to investigate the impact of hospital type, physician specialty, treatment pattern, and patient profile on clinical outcomes. ⋯ Achieving adequate control of risk factors for cardiovascular disease in patients with type 2 diabetes remains a clinical challenge. Interventions to achieve control of 3Bs coupled with modification of additional cardiovascular disease predictors are crucial for optimization of clinical outcomes in patients with type 2 diabetes.