Khan and colleagues' meta-analysis addresses the care of patients with atrial fibrillation following coronary stent placement who require anticoagulation to mitigate stroke risk and antiplatelet therapy to promote stent patency. The editorial discusses the findings and how to best balance the risks of bleeding and thrombosis that such patients face.
Thyrotoxicosis is a general term for excess circulating and tissue thyroid hormone levels, whereas hyperthyroidism specifically denotes disorders involving a hyperactive thyroid gland (Graves disease, toxic multinodular goiter, toxic adenoma). Diagnosis and determination of the cause rely on clinical evaluation, laboratory tests, and imaging studies. Hyperthyroidism is treated with antithyroid drugs, radioactive iodine ablation, or thyroidectomy. Other types of thyrotoxicosis are monitored and treated...
Background:The safety and effectiveness of dual therapy (direct oral anticoagulant [DOAC] plus P2Y12 inhibitor) versus triple therapy (vitamin K antagonist plus aspirin and P2Y12 inhibitor) in patients with nonvalvular atrial fibrillation (AF) after percutaneous coronary intervention (PCI) is unclear.Purpose:To examine the effects of dual versus triple therapy on bleeding and ischemic outcomes in adults with AF after PCI.Data Sources:Searches of PubMed, EMBASE, and the Cochrane Library (inception...
Venous thromboembolism (VTE), which includes both deep venous thrombosis and pulmonary embolism, is a common and potentially fatal condition. Medical inpatients are at high risk for VTE because of immobility as well as acute and chronic illness. Several randomized trials demonstrated that chemoprophylaxis, or low-dose anticoagulation, prevents VTE in selected medical inpatients. The 2018 American Society of Hematology clinical practice guideline on prophylaxis for hospitalized and nonhospitalized...
Background:Observational studies using traditional research designs suggest that influenza vaccination reduces hospitalizations and mortality among elderly persons. Accordingly, health authorities in some countries prioritize vaccination of this population. Nevertheless, questions remain about this policy's effectiveness given the potential for bias and confounding in observational data.Objective:To determine the effectiveness of the influenza vaccine in reducing hospitalizations and mortality among...
This is a terrible, horrible, no good, very bad birthday.
But before I even started my first rotation, I met a new companion: an invisible ticking time bomb.
Post hoc analyses of randomized trial data can help answer important questions by making use of valuable data collected in controlled settings. Using trial data to compare nonrandomized exposures requires care because the comparisons are not protected by randomization. This article helps readers understand the potential biases that need to be considered when evaluating such studies.
Background:FLU-v is a broad-spectrum influenza vaccine that induces antibodies and cell-mediated immunity.Objective:To compare the safety, immunogenicity, and exploratory efficacy of different formulations and dosing regimens of FLU-v versus placebo.Design:Randomized, double-blind, placebo-controlled, single-center phase 2b clinical trial. (ClinicalTrials.gov: NCT02962908; EudraCT: 2015-001932-38)Setting:The Netherlands.Participants:175 healthy adults aged 18 to 60 years.Intervention:0.5-mL subcutaneous...
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