Weekly Guideline - 2013 ASE Peri-op TEE

 "Basic Perioperative Transesophageal Echocardiography Examination: A Consensus Statement of the American Society of Echocardiography and the Society of Cardiovascular Anesthesiologists"

http://www.asecho.org/wordpress/wp-content/uploads/2013/05/Basic-Perioperative-TEE-Exam.pdf

JACC -

"Fasting Triglycerides Predict Recurrent Ischemic Events in Patients With Acute Coronary Syndrome Treated With Statins"

"Conclusions  Among patients with ACS treated effectively with statins, fasting triglycerides predict long-term and short-term cardiovascular risk. Triglyceride-rich lipoproteins may be an important additional target for therapy. (A Study of RO4607381 in Stable Coronary Heart Disease Patients With Recent Acute Coronary Syndrome; NCT00658515)"

http://content.onlinejacc.org/article.aspx?articleID=2297631  

BMJ - "Use of combined oral contraceptives and risk of venous thromboembolism: nested case-control studies using the QResearch and CPRD databases"

"Use of combined oral contraceptives and risk of venous thromboembolism: nested case-control studies using the QResearch and CPRD databases"

"Conclusions In these population based, case-control studies using two large primary care databases, risks of venous thromboembolism associated with combined oral contraceptives were, with the exception of norgestimate, higher for newer drug preparations than for second generation drugs."

http://www.bmj.com/content/350/bmj.h2135 

NEJM - "Efficacy of an Adjuvanted Herpes Zoster Subunit Vaccine in Older Adults"

"Efficacy of an Adjuvanted Herpes Zoster Subunit Vaccine in Older Adults"

"CONCLUSIONS

The HZ/su vaccine significantly reduced the risk of herpes zoster in adults who were 50 years of age or older. Vaccine efficacy in adults who were 70 years of age or older was similar to that in the other two age groups. (Funded by GlaxoSmithKline Biologicals; ZOE-50 ClinicalTrials.gov number, NCT01165177.)"  

http://www.nejm.org/doi/full/10.1056/NEJMoa1501184?query=featured_home

JAMA - Amyloid & Dementia

"Prevalence of Cerebral Amyloid Pathology in Persons Without Dementia
A Meta-analysis"

"Conclusions and Relevance  Among persons without dementia, the prevalence of cerebral amyloid pathology as determined by positron emission tomography or cerebrospinal fluid findings was associated with age, APOE genotype, and presence of cognitive impairment. These findings suggest a 20- to 30-year interval between first development of amyloid positivity and onset of dementia."

https://jama.jamanetwork.com/article.aspx?articleid=2293295

Weekly Guideline - 2013 ESC Diabetes & Cardiovascular Care

"Diabetes, Pre-Diabetes and Cardiovascular Diseases developed with the EASD"

http://www.escardio.org/Guidelines-&-Education/Clinical-Practice-Guidelines/Diabetes-Pre-Diabetes-and-Cardiovascular-Diseases-developed-with-the-EASD

CIRC - "Coronary Artery Bypass Grafting in Patients 50 Years or Younger A Swedish Nationwide Cohort Study"

"Coronary Artery Bypass Grafting in Patients 50 Years or Younger
 A Swedish Nationwide Cohort Study"
"Conclusions—Long-term survival and freedom from major cardiovascular events after CABG was better in young adults than in older patients. Factors significantly associated with an elevated long-term risk of death or adverse outcome were similar to well-known risk factors for older age groups following CABG."
http://circ.ahajournals.org/content/131/20/1748.full

BMJ - GI Bleeding Risks: dabigatran, rivaroxaban, and warfarin

"Comparative risk of gastrointestinal bleeding with dabigatran, rivaroxaban, and warfarin: population based cohort study"

"Conclusions: The risk of gastrointestinal bleeding related to novel oral anticoagulants was similar to that for warfarin. Caution should be used when prescribing novel oral anticoagulants to older people, particularly those over 75 years of age."

http://www.bmj.com/content/350/bmj.h1857 

NEJM - High Flow O2 in Acute Respiratory Failure

"High-Flow Oxygen through Nasal Cannula in Acute Hypoxemic Respiratory Failure"

"CONCLUSIONS

In patients with nonhypercapnic acute hypoxemic respiratory failure, treatment with high-flow oxygen, standard oxygen, or noninvasive ventilation did not result in significantly different intubation rates. There was a significant difference in favor of high-flow oxygen in 90-day mortality. (Funded by the Programme Hospitalier de Recherche Clinique Interrégional 2010 of the French Ministry of Health; FLORALI ClinicalTrials.gov number, NCT01320384.)"  

http://www.nejm.org/doi/full/10.1056/NEJMoa1503326?query=featured_home 

JAMA - Amyloid on PET in Dementia

"Prevalence of Amyloid PET Positivity in Dementia Syndromes A Meta-analysis"

"Conclusions and Relevance  Among participants with dementia, the prevalence of amyloid positivity was associated with clinical diagnosis, age, and APOE genotype. These findings indicate the potential clinical utility of amyloid imaging for differential diagnosis in early-onset dementia and to support the clinical diagnosis of participants with AD dementia and noncarrier APOE ε4 status who are older than 70 years."

https://jama.jamanetwork.com/article.aspx?articleid=2293296 

Weekly Guideline - 2014 AAP Bronchioloitis

"Clinical Practice Guideline: The Diagnosis, Management, and Prevention of Bronchiolitis"

http://pediatrics.aappublications.org/content/134/5/e1474.full?sid=0691dbbf-c6bd-4582-aa41-53277a262fe3

JACC - Fitness & Lipids

"The Effect of Cardiorespiratory Fitness on Age-Related Lipids and Lipoproteins"

"Conclusions  Our investigation reveals a differential trajectory of lipids and lipoproteins with aging according to CRF in healthy men and suggests that promoting increased CRF levels may help delay the development of dyslipidemia."

http://content.onlinejacc.org/article.aspx?articleID=2290814

Lancet - Rheumatoid Biologics & Infections

"Risk of serious infection in biological treatment of patients with rheumatoid arthritis: a systematic review and meta-analysis"

"Interpretation

Standard-dose and high-dose biological drugs (with or without traditional DMARDs) are associated with an increase in serious infections in rheumatoid arthritis compared with traditional DMARDs, although low-dose biological drugs are not. Clinicians should discuss the balance between benefit and harm with the individual patient before starting biological treatment for rheumatoid arthritis."

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)61704-9/abstract

NEJM - Long Term Ticagrelor After MI

"Long-Term Use of Ticagrelor in Patients with Prior Myocardial Infarction"
 
"CONCLUSIONS

In patients with a myocardial infarction more than 1 year previously, treatment with ticagrelor significantly reduced the risk of cardiovascular death, myocardial infarction, or stroke and increased the risk of major bleeding. (Funded by AstraZeneca; PEGASUS-TIMI 54 ClinicalTrials.gov number, NCT01225562.)"

http://www.nejm.org/doi/full/10.1056/NEJMoa1500857

JAMA (Psychiatry) - Delirium Prevention

"Ramelteon for Prevention of Delirium in Hospitalized Older Patients"

"Conclusions and Relevance
Ramelteon administered nightly to elderly patients admitted for acute care may provide protection against delirium. This finding supports a possible pathogenic role of melatonin neurotransmission in delirium."

https://jama.jamanetwork.com/article.aspx?articleid=2281684

Weekly Guideline - 2015 AHA "Congenital Heart Disease in the Older Adult"

"Congenital Heart Disease in the Older Adult"

http://circ.ahajournals.org/content/early/2015/04/20/CIR.0000000000000204

CIRC - Survival After Out-of-Hospital Cardiac Arrest

 "Survival After Out-of-Hospital Cardiac Arrest in Relation to Age and Early Identification of Patients With Minimal Chance of Long-Term Survival"

"Conclusions—All age groups experienced a large temporal increase in survival on hospital arrival, but the increase in 30-day survival was most prominent in the young. With the use of only 2 criteria, it was possible to identify patients with a minimal chance of 30-day survival."

http://circ.ahajournals.org/content/131/18/1536.abstract 

BMJ - Duration of dual antiplatelet therapy after PCI with DES: meta-analysis

"Optimal duration of dual antiplatelet therapy after percutaneous coronary intervention with drug eluting stents: meta-analysis of randomised controlled trials"

"Conclusions Compared with a standard 12 month duration, short term DAPT (<12 months) after drug eluting stent implementation yields reduced bleeding with no apparent increase in ischaemic complications, and could be considered for most patients. In selected patients with low bleeding risk and very high ischaemic risk, extended DAPT (>12 months) could be considered. The increase in all cause but not cardiovascular death with extended DAPT requires further investigation."

http://www.bmj.com/content/350/bmj.h1618 

NEJM - Ablation for Persistent A Fib

"Approaches to Catheter Ablation for Persistent Atrial Fibrillation"

"CONCLUSIONS

Among patients with persistent atrial fibrillation, we found no reduction in the rate of recurrent atrial fibrillation when either linear ablation or ablation of complex fractionated electrograms was performed in addition to pulmonary-vein isolation. (Funded by St. Jude Medical; ClinicalTrials.gov number, NCT01203748.)"

http://www.nejm.org/doi/full/10.1056/NEJMoa1408288?query=featured_home 

JAMA - Nontoxigenic Clostridium difficile M3 for Prevention C dif

"Administration of Spores of Nontoxigenic Clostridium difficile Strain M3 for Prevention of Recurrent C difficile Infection"

"Conclusions and Relevance  Among patients with CDI who clinically recovered following treatment with metronidazole or vancomycin, oral administration of spores of NTCD-M3 was well tolerated and appeared to be safe. Nontoxigenic C difficile strain M3 colonized the gastrointestinal tract and significantly reduced CDI recurrence."

https://jama.jamanetwork.com/article.aspx?articleid=2281703  

Weekly Guideline - 2015 AHA HFSA: Heart Failure in Skilled Nursing Facilities

"Heart Failure Management in Skilled Nursing Facilities A Scientific Statement From the American Heart Association and the Heart Failure Society of America"

http://circheartfailure.ahajournals.org/content/early/2015/04/07/HHF.0000000000000005.full.pdf