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Community-acquired MRSA pericarditis

Only 2 cases of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) pericarditis have been reported in the English literature. Over the last 15 years, CA-MRSA has emerged as an increasingly common pathogen that is genetically and epidemiologically different from hospital-acquired MRSA (HA-MRSA).

Assessing and Treating Complex Migraine

Proper diagnosis and treatment requires that physicians and patients understand the symptoms and clinical presentation of this complicated migraine condition.

Hyperglycemia and platelet function in diabetic patients: Relevance to acute myocardial ischemia and infarction

Diabetic patients with acute coronary syndromes are at higher risk for mortality, even if they have ST-segment elevation myocardial infarction. Diabetic patients with unstable angina/non–Q-wave infarction have impaired platelet responsiveness to nitric oxide, a physiological anti-aggregating autocoid. The extent of this impairment depends on the degree of hyperglycemia. Rapid correction of hyperglycemia with infused insulin restores responsiveness to nitric oxide, thus ameliorating platelet dysfunction.

Chronic diuretic use and increased mortality and hospitalization in heart failure

Diuretic use is associated with activation of neurohormones and disease progression in heart failure. Yet, diuretics are commonly prescribed, although little is known about their long-term effects. We performed a study based on propensity score matching, which indicated that in subjects with ambulatory, chronic, mild-to-moderate heart failure, diuretic use was associated with increased mortality and hospitalization. These findings call into question the wisdom of using long-term diuretic therapy in heart failure patients who are asymptomatic or minimally symptomatic.

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Creatine kinase-MB elevation following coronary artery bypass graft surgery: What is its significance and should it be measured in all patients?

In their study consisting of coronary artery bypass graft (CABG) patients recruited from 4 major trials, Mahaffey found that creatine kinase-myocardial band (CK-MB) elevations following CABG surgery are independently associated with an increased risk of mortality in patients with non–ST-segment elevation acute coronary syndromes, especially if the peak CK-MB level is > 5 x the upper limit of normal (ULN).

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Atorvastatin pretreatment in early percutaneous coronary intervention

According to results of the Atorvastatin for Reduction of Myocardial Damage During Angioplasty-Acute Coronary Syndromes (ARMYDA-ACS) trial, short-term pretreatment with high-dose atorvastatin prior to percutaneous coronary intervention improves clinical outcome in subjects with unstable angina and non-ST-segment elevation myocardial infarction. These findings support the upstream administration of high-dose statins in subjects with acute coronary syndrome treated with an early invasive strategy.

How to Be the Perfect Heart Patient

There are difficult patients, and ideal patients. A cardiologist offers advice on relating to them all.

FDA Clears AbbVie to Produce Oral Powder form of Norvir

The powder form will be more easily administered to pediatric patients, AbbVie says.

Managing Chronic Cirrhosis After Progression to Liver Failure, Gastrointestinal Bleeding

In his presentation, George Therapondos, MD, a hepatologist at the Ochsner Medical Center, detailed how to manage inpatients with cirrhosis that progresses to liver failure and gastrointestinal bleeding.

Outcomes in women vs men with heart failure and preserved ejection fraction

The epidemiologic finding that women with heart failure have better overall survival than men may be because of the higher prevalence of diastolic heart failure or heart failure with preserved ejection fraction (HF-PEF) among women.

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