The American journal of medicine
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Randomized Controlled Trial Multicenter Study
Association of electrocardiogram findings with clinical outcomes in patients with chronic coronary syndrome: an analysis of the ISCHEMIA trials.
We aimed to investigate the association of electrocardiogram (ECG) findings with outcomes in patients with chronic coronary syndrome. ⋯ In patients with chronic coronary syndrome, an abnormal ECG tracing was associated with an increased risk of cardiovascular death. Our findings underscore the importance of the ECG in cardiovascular risk stratification and prognostication.
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This narrative review takes a personal approach in detailing the progression of cognitive decline in a loved one, and the measures taken to care for the patient. The author provides suggestions for a compassionate care plan and advice for clinicians helpful to both patient and caregiver.
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Review Comparative Study
Comparability of control and comparison groups in studies assessing long COVID.
Awareness of long coronavirus disease (COVID) began primarily through media and social media sources, which eventually led to the development of various definitions based on methodologies of varying quality. We sought to characterize comparison groups in long COVID studies and evaluate comparability of the different groups. ⋯ Long COVID studies in high-impact journals primarily examine symptoms and risk factors of long COVID; often lack an adequate comparison group and often do not control for potential confounders. Our results suggest that standardized definitions for long COVID, which are often based on data from uncontrolled and potentially biased studies, should be reviewed to ensure that they are based on objective data.
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While there has been a decline in the use of digoxin in patients with heart failure and atrial fibrillation, acute and chronic digoxin toxicity remains a significant clinical problem. Digoxin's narrow therapeutic window and nonspecific signs and symptoms of toxicity create clinical challenges and uncertainty around the diagnostic criteria of toxicity and responsive treatment choices for the bedside clinician. ⋯ The results demonstrate agreement about the need to consider time of ingestion and nature of the exposure (ie, acute, acute-on-chronic, chronic) and the use of digoxin immune Fab for life-threatening exposure to decrease risk of death. While several areas of continued uncertainty were identified, this work offers formalized guidance that may help providers better manage this persistent clinical challenge.