Aspirin and clopidogrel compared with clopidogrel alone after recent CVA/TIA (MATCH Trial)
Antiplatelet therapy is the cornerstone of secondary prevention of Stroke and TIA. But in contrast to acute coronary syndrome where patients get one year of aspirin plus clopidogrel, is there evidence of benefit for combination therapy after stroke/TIA? This article…
Methotrexate and Mortality in Patients with Rheumatoid Arthritis
Methotrexate is the most common choice for disease-modifying anti-rheumatic drug (DMARD) for rheumatoid arthritis. This prospective study assesses the effect of methotrexate on mortality in a cohort of patients with rheumatoid arthritis. Some questions to consider while reviewing this article:…
Comparison of 8 vs 15 Days of Antibiotic Therapy for Ventilator-Associated Pneumonia in Adults
The optimal duration of antibiotic treatment for ventilator-associated pneumonia (VAP) is not known. Shortening the course of therapy may help decrease antibiotic resistance and adverse effects of giving prolonged antibiotics. This study looks to establish that mortality and recurrent infections…
Correction of Anemia with Epoetin Alfa
Anemia is a common complication of chronic kidney disease which is typically treated with recombinant human erythropoietin. However the ideal goal hemoglobin is not well established. This study looks to answer if a lower-goal hemoglobin CKD patients shows decreased adverse…
Hydrocortisone Therapy for Patients with Septic Shock
Sepsis continues to affect 1.5 million people and lead to 250,000 deaths in the U.S., according to the CDC. The CORTICUS study reviewed here (article below) is the landmark study evaluating the potential benefit of corticosteroids in septic patients. As…
Reduced Lung-Cancer Mortality with Low-Dose CT Screening
Lung cancer continues to be the leading cause of cancer death, ahead of colorectal, breast, and prostate cancers. However, screening strategies have been comparatively limited. This landmark article demonstrates the use of low-dose CT to screen for lung cancer, and…
Combination Therapy in Influenza
Influenza is still in season, and we are certainly seeing primary flu and secondary complications like pneumonia. So here’s an interesting question: does combination therapy with the addition of clarithromycin and naproxen in patients hospitalized for acute influenza have any benefit?
Prasugrel versus Clopidogrel in Patients with Acute Coronary Syndromes
Antagonists of the P2Y12 ADP receptor, in addition to aspirin, are the mainstay of treatment of non-ST elevation acute coronary syndromes (NSTE-ACS). Although Clopidogrel (Plavix®) has been widely used for years, newer agents have come into use, including Ticagrelor (Brilinta®) and Prasugrel…
Effect of IV Albumin on Renal Impairment and Mortality in Patients with Cirrhosis and SBP
As general internists, we often encounter and are expected to medically manage the acute complications of decompensated cirrhosis: Gastrointestional bleed Spontaneous bacterial peritonitis Hepatic encephalopathy Hepatorenal syndrome This article tackles an important cornerstone of treatment for SBP: the use of…