Missouri medicine
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Acute disorders of the kidney occur in up to two-thirds of patients in the intensive care unit. The diagnosis is associated with increased mortality and increased hospital stay. ⋯ A standardized definition regarding acute kidney injury was published in 2004. This has led to improvements in measuring mortality and treatment outcomes with a more targeted approach to caring for these difficult to treat patients.
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Aortic stenosis is the most common form of valvular heart disease in the Western world and until recently, surgical aortic valve replacement has been the only treatment available for patients with this disease that has been shown to improve both symptoms and survival. Transcatheter aortic valve replacement has emerged as a new therapy for patients with severe aortic stenosis who are poor surgical candidates due to their elevated surgical risk. As longer follow up is obtained and improvements continue to be made in the current available prostheses, transcatheter aortic valve replacement will likely become a treatment alternative for high-risk patients with severe aortic stenosis.
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Cardiovascular disease is the leading cause of death in the United States and most developed countries. The majority of deaths are due to coronary artery disease. It is estimated that 419,000 coronary artery bypass grafting (CABG) procedures were performed in the United States in 2009 for the surgical treatment of coronary artery disease. Off-pump CABG (without the use of cardiopulmonary bypass) is an attractive less invasive operative approach with multiple patient benefits.
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By drawing boundaries between their personal and professional lives, physicians can protect their practices and themselves while also still achieving their true goal: providing quality care to their patients.