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Fool Me Once: An Uncommon Presentation of PE
​BY FREDDIE IRIZARRY-DELGADO; VAROON KAKAIYA; & AHMED RAZIUDDIN, MDAn 86-year-old African-American woman was brought to the ED by her daughter after two days of nutritional neglect, abdominal pain, and altered mental status. Her daughter said her mother felt lightheaded, appeared dehydrated, and vomited nonbilious watery fluid once. The patient had a history of diabetes mellitus type 2, DVT/PE, dementia, and early signs of parkinsonism.Her vital signs were remarkable only for tachypnea (24 bpm). Her troponin I was markedly elevated at 1.7 ng/mL. A D-dimer was ordered because of her history of unprovoked DVT/PE, and i...
Source: The Case Files - November 27, 2018 Category: Emergency Medicine Tags: Blog Posts Source Type: research

Studies: Low-Dose Aspirin May Not Prevent Initial Heart Attack, Stroke
Taking a low-dose aspirin every day has long been known to cut the chances of another heart attack, stroke or other heart problem in people who already have had one, but the risks don’t outweigh the benefits for most other folks, major new research finds. Although it’s been used for more than a century, aspirin’s value in many situations is still unclear. The latest studies are some of the largest and longest to test this pennies-a-day blood thinner in people who don’t yet have heart disease or a blood vessel-related problem. One found that aspirin did not help prevent first strokes or heart attacks...
Source: WBZ-TV - Breaking News, Weather and Sports for Boston, Worcester and New Hampshire - August 27, 2018 Category: Consumer Health News Authors: Health – CBS Boston Tags: Boston News Health Healthwatch aspirin Source Type: news

Over-the-counter analgesic powder use in patients presenting with intracerebral hemorrhage: A case series
Conclusions: Over-the-counter analgesic powders containing high doses of aspirin including BC Powder and Goody's Powder may contribute to ICH in patients with no or minimal risk factors. Providers should inquire about the use of these powders in ICH patients particularly among African Americans.
Source: Medicine - April 1, 2018 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

National Assessment of Quality Programs in Emergency Medical Services.
CONCLUSIONS: EMS agencies in the United States have significant practice variability with regard to quality improvement resources, medical direction and specific clinical quality measures. More research is needed to understand the impact of this variation on patient care outcomes. PMID: 29297735 [PubMed - as supplied by publisher]
Source: Prehospital Emergency Care - January 5, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Yosprala: A Fixed Dose Combination of Aspirin and Omeprazole
Cardiovascular disease is the leading cause of morbidity and mortality in the United States. Patients who survive a primary cerebrovascular or cardiovascular event are at increased risk of a subsequent occurrence. Antiplatelet therapy plays an essential role for secondary prevention in individuals with stroke, transient ischemic attack, acute or chronic artery disease, or peripheral arterial disease. Maintaining high-risk patients on low-dose aspirin therapy is a fundamental component of management. However, poor adherence, secondary to the drug’s gastrointestinal side effects, has been associated with negative cardiovas...
Source: Cardiology in Review - January 1, 2018 Category: Cardiology Tags: New Therapy Update Source Type: research

HIV-positive adults are under-treated for cardiovascular problems compared to those without HIV
This study provides evidence that U.S. policymakers and professional societies should focus on improving the quality of the cardiovascular care that people who are HIV-positive receive.AUTHORSStudy authors are Dr. Joseph Ladapo, Dr. Adam Richards, Cassandra DeWitt, Nina Harawa, Steven Shoptaw, Dr. William Cunningham and Dr. John Mafi, all of UCLA. Mafi is also associated with Rand Corporation.JOURNALThestudy is published in the Journal of the American Heart Association.FUNDINGGrants from the National Heart, Lung and Blood Institute, National Institute on Minority Health and Health Disparities, and National Institute of Men...
Source: UCLA Newsroom: Health Sciences - November 22, 2017 Category: Universities & Medical Training Source Type: news

Review of Article: Rivaroxaban with or without Aspirin in Stable Cardiovascular Disease. Eikelboom JW, Connolly SJ, Bosch J, et  al. for the COMPASS Investigators
Cardiovascular disease accounts for nearly 801,000 deaths in  the United States.1 Patients with vascular disease have a 20%-60% increased risk of a myocardial infarction (MI), a 40% increased risk of a stroke, and a 2- to 6-fold increase of death due to cardiovascular disease.2,3 The primary goal in antiplatelet therapy is to reduce the risk of MI, stroke, o r vascular death in patients with atherosclerosis and has been the cornerstone in medical management of the patient with cardiovascular disease.
Source: Journal of Vascular Nursing - October 24, 2017 Category: Nursing Authors: Debra Kohlman-Trigoboff Tags: Research Column Source Type: research

Recurrent Ischemic Stroke: Strategies for Prevention.
Abstract Recurrent strokes make up almost 25% of the nearly 800,000 strokes that occur annually in the United States. Risk factors for ischemic stroke include hypertension, diabetes mellitus, hyperlipidemia, sleep apnea, and obesity. Lifestyle modifications, including tobacco cessation, decreased alcohol use, and increased physical activity, are also important in the management of patients with a history of stroke or transient ischemic attack. Antiplatelet therapy is recommended to reduce the risk of recurrent ischemic stroke. The selection of antiplatelet therapy should be based on timing, safety, effectiveness, ...
Source: American Family Physician - October 1, 2017 Category: Primary Care Authors: Oza R, Rundell K, Garcellano M Tags: Am Fam Physician Source Type: research

Atrial Fibrillation Decision Support Tool: Population Perspective
Conclusions Availability of DOACs increases the proportion of patients for whom oral anticoagulation therapy is recommended in a real-world cohort of AF patients and increased projected QALYs by more than 1500 when all patients are receiving thromboprophylaxis as recommended by the AFDST compared with current treatment.
Source: American Heart Journal - August 23, 2017 Category: Cardiology Source Type: research

Heartburn drugs linked to premature death
Conclusion This larger set of observational data finds that PPI drugs are associated with an increase in the risk of early death compared with either H2 blockers or no acid suppression drugs. This was the case for participants both with and without gastrointestinal problems. It also appears as though the longer the PPIs drugs are taken, the greater the risk of death. Considering that these drugs are widely used in the UK, these findings may cause concern. But the research has a number of important limitations: The study was conducted in a population of mostly white, older US male veterans, which might limit the ability...
Source: NHS News Feed - July 4, 2017 Category: Consumer Health News Tags: Medication Source Type: news

Vital signs: avoidable deaths from heart disease, stroke, and hypertensive disease - United States, 2001-2010.
Conclusions: Nearly one fourth of all cardiovascular disease deaths are avoidable. These deaths disproportionately occurred among non-Hispanic blacks and residents of the South. Persons aged <65 years had lower rates than those aged 65-74 years but still accounted for a considerable share of avoidable deaths and demonstrated less improvement. Implications for Public Health Practice: National, state, and local initiatives aimed at improving health-care systems and supporting healthy behaviors are essential to reducing avoidable heart disease, stroke, and hypertensive disease deaths. Strategies include promoting the ABCS ...
Source: MMWR Morb Mortal Wkl... - September 6, 2013 Category: Epidemiology Authors: Centers for Disease Control and Prevention (CDC) Tags: MMWR Morb Mortal Wkly Rep Source Type: research

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