The American journal of medicine
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Polypharmacy, commonly defined as taking ≥5 medications, is an undesirable state associated with lower quality of life. Strategies to prevent polypharmacy may be an important priority for patients. We sought to examine the association of healthy lifestyle, a modifiable risk factor, with incident polypharmacy. ⋯ Healthier lifestyle was associated with lower risk for incident polypharmacy.
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For patients on warfarin for mechanical heart valve replacement, the 2020 American College of Cardiology and American Heart Association Guidelines recommend only adding aspirin in patients with a specific indication for antiplatelet therapy. This contrasts with prior guidelines, which recommended concomitant aspirin therapy. We sought to assess the prevalence of guideline-discordant aspirin use among patients on warfarin for mechanical heart valve replacement and to compare adverse event rates among patients with and without concomitant aspirin. ⋯ A significant proportion of patients on warfarin for mechanical heart valve replacement are on guideline-discordant aspirin. Aspirin deprescribing in select patients may safely reduce bleeding events.
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Recognizing and attempting management of patients with urgent or emergent conditions is one of the Association of American Medical Colleges Core Entrustable Professional Activities (#10) and a skill desired of new interns. However, given the acuity of these patient conditions, medical students often struggle to gain experience in these situations. Virtual reality could help fill this void while lowering costs and resources compared with high-fidelity simulation. ⋯ We demonstrated that virtual reality is an acceptable, cost-effective, and feasible modality to teach medical students how to recognize and attempt management of urgent clinical situations (Core Entrustable Professional Activity 10).