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Transitional Care Interventions for Heart Failure: What Are the Mechanisms?

  Two decades ago, heart failure clinics were proposed widely as an effective means of improving care.1 Despite dozens of trials over subsequent years, it has often been difficult to ascertain the true effectiveness of such programs due to poor descriptions of study populations, interventions, comparators, and outcomes. This is compounded by the use of terms […]

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Sleep-Disordered Breathing in Obese Hospitalized Patients (video)

Sleep-disordered breathing is a common sleep disorder. Recent studies have shown that hospitalized obese patients have a high likelihood of unrecognized sleep-disordered breathing. However, no systematic large study has so far evaluated the outcomes of a screening program. This study provides demographic, clinical, and outcome data from a screening program at a tertiary care academic […]

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Cardiology Consultation in the Emergency Department

Re-hospitalization after discharge for acute decompensated heart failure is a common problem. Low-socioeconomic urban patients suffer high rates of re-hospitalization and often over-utilize the emergency department (ED) for their care. We hypothesized that early consultation with a cardiologist in the ED can reduce re-hospitalization and health care costs for low-socioeconomic urban patients with acute decompensated […]

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Skin examination was remarkable for multiple diffusely distributed erythematous patches with central clearing, consistent with erythema chronicum migrans.

Case of Reversible Complete Heart Block

    A previously healthy Caucasian 22-year-old man presented to a southern Quebec community hospital with syncopal episodes for 1 week. He was found to be hypotensive and bradycardic (heart rate 36 beats per minute), owing to third-degree atrioventricular (AV) block, which did not respond to atropine. A perfusion of isoprenaline was started, and the […]

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The Malnourished Heart: An Unusual Case of Heart Failure

To the Editor: A 66-year-old woman with no past medical history was admitted for 3 months of worsening dyspnea, lower extremity edema, and orthopnea. She was not taking medications or supplements. She denied chest pain, recent infections, fevers, toxin exposures, or use of drugs or alcohol. She reported patchy hair loss on her scalp, bruises […]

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Love plot displaying absolute standardized differences for 32 baseline characteristics of hospitalized Medicare beneficiaries with heart failure and left ventricular ejection fraction <45% receiving and not receiving a new discharge prescription for angiotensin-converting enzyme inhibitors or angiotensin receptor blocker, before and after propensity score matching.

Renin-Angiotensin System Inhibition and Lower 30-Day All-Cause Readmission in Medicare Beneficiaries with Heart Failure

  Heart failure is the leading cause for 30-day all-cause readmission, the reduction of which is a goal of the Affordable Care Act. There is a growing interest in understanding the impact of evidence-based heart failure therapy on 30-day all-cause readmission. In the current study, we examined the impact of angiotensin-converting enzyme inhibitors or angiotensin […]

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