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Concomitant Use of Direct Oral Anticoagulants with Antiplatelet Agents and the Risk of Major Bleeding in Patients with Nonvalvular Atrial Fibrillation

Patients with nonvalvular atrial fibrillation commonly have comorbidities requiring concurrent use of oral anticoagulants and antiplatelets. There are no real-world data on the comparative safety of concomitant antithrombotic treatments in the era of direct oral anticoagulant (DOACs). Thus, we compared the incidence of intracranial hemorrhage, gastrointestinal bleeding, and other major bleeding between concomitant DOAC-antiplatelet use […]

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Pheidippides’ sudden cardiac death in the Atheneum in 490 B.C. after declaring victory over the invading Persian army on the Plains of Marathon (by anonymous).

Unforseeing one! Yes, he fought on Marathon day: So, when Persia was dust, all cried “To Akropolis! Run, Pheidippides, one race more. Till in Athens he broke, ‘Rejoice, we conquer!” Joy in his blood bursting his heart, he died—the bliss! ‘Pheidippides’ by Robert Browning, 1879.

Aspirin to Prevent Sudden Cardiac Death in Athletes with High Coronary Artery Calcium Scores

While proficient cardiac resuscitation has improved survival following cardiac arrest during road races in Japan, this accomplishment does not address coronary artery disease as the underlying cause of an increasing frequency of cardiac arrest in middle-aged men during marathons and ironman triathlons in the United States since the year 2000. Based on the high prevalence […]

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Impact of Geriatrician-Performed Comprehensive Geriatric Care on Medication Use and Cognitive Function in Older Adults Referred to a Non-Hospital-Based Rehabilitation Unit

Eighty-eight percent of older adults referred to Danish non-hospital-based rehabilitation units used ≥5 regular drugs per day at the beginning of rehabilitation. The aim of the study was to explore whether geriatrician-performed comprehensive geriatric care had an impact on medication use and cognitive function in older adults after a 90-day follow-up. Methods There were 368 […]

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Variation in the Use of Warfarin and Direct Oral Anticoagulants in Atrial Fibrillation and Associated Cost Implications

Little is known about national patterns of anticoagulant use among patients with atrial fibrillation after the availability of direct oral anticoagulants (DOACs) and the associated implications for healthcare spending. Methods The Medical Expenditure Panel Survey, a nationally representative survey, collects detailed information about prescription drug use, cost, and medical diagnoses. Using International Classification of Disease […]

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Right arm extensor surface (A) and left arm volar surface (C) prior to steroid therapy, depicting mottled erythema together with subcutaneous calcific deposits at the volar aspect of the upper arm, forearm, and antecubital fossa. Right arm (B) and left arm (D) after initiation of high-dose steroid therapy, showing marked improvement and resolution in erythema.

Febrile Calcinosis in Scleroderma

The collagen vascular diseases can be challenging for the internist and are associated with higher utilization of resources and less favorable outcomes among patients admitted to the inpatient medicine services.1 In this context, the acquisition of proficiency in recognizing a range of disease manifestations, common and uncommon, and familiarity with the appropriate therapeutic interventions are critical […]

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Relevant diagnostics and physical examination data. (A) Initial electrocardiogram on presentation to the critical care unit. (B) Still image of clonus on physical examination (refer to supplementary materials for video). (C) Electrocardiogram on discharge after successful treatment of serotonin syndrome.

Serotonin Syndrome Masquerading as Ventricular Tachycardia Storm

A 60-year-old woman with bipolar disorder presented to a local hospital after being found unresponsive at home. When assessed by emergency medical services, she was found to be tachycardic to 180 beats per minute and received 3 doses of adenosine on transport with no effect. Given concern for altered mental status, she was intubated for […]

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