Citation: Short PM, Lipworth SI, Elder DH, Schembri S, Lipworth BJ. Effect of beta blockers in treatment of chronic obstructive pulmonary disease: a retrospective cohort study. Br Med J. 2011;342:d2549.
CLINICAL SHORTS
ULTRASOUND IS THE INVESTIGATION OF CHOICE FOR FATTY-LIVER SCREENING
Meta-analysis of 4,720 participants showed sensitivity and specificity of ultrasound in detecting fatty liver to be 84.8% and 93.6%, respectively, which is similar to both CT and MRI while being cheaper, safer, and easier to access.
Citation: Hernaez, R, Lazo M, Bonekamp, S, et al. Diagnostic accuracy and reliability of ultrasonography for the detection of fatty liver: a meta-analysis. Hepatology. 2011;54:1082-1090.
DABIGATRAN SHOWN TO BE COST-EFFECTIVE FOR STROKE PROPHYLAXIS IN ATRIAL FIBRILLATION IN SOME PATIENTS
A decision-analysis model based on prior studies’ results indicates that dabigatran 150 mg twice daily is cost-effective for patients with atrial fibrillation who are at average bleeding risk and higher risk for stroke.
Citation: Shah SV, Gage BF. Cost-effectiveness of dabigatran for stroke prophylaxis in atrial fibrillation. Circ. 2011;123:2562-2570.
AGGRESSIVE GLYCEMIC CONTROL DOES NOT IMPROVE CLINICAL OUTCOMES IN DIABETIC PATIENTS UNDERGOING CORONARY ARTERY BYPASS SURGERY
In diabetic patients undergoing coronary artery bypass surgery, tighter glycemic control (90 to 120 mgs/dL) was not associated with better clinical outcome, compared with moderate control (120 to 180 mgs/dL) but was associated with significant hypoglycemia.
Citation: Lazar HL, McDonnell MM, Chipkin S, Fitzgerald C, Bliss C, Cabral H. Effects of agressive versus moderate glycemic control on clinical outcomes in diabetic coronary artery bypass graft patients. Ann Surg. 2011;254:458-463.
VERY FEW SMOKERS GET SMOKING-CESSATION TREATMENTS AFTER ACUTE MYOCARDIAL INFARCTION
Only 14% of patients were prescribed smoking-cessation treatments on discharge after acute myocardial infarction, and prescription rates varied significantly among different hospitals in this multicenter study.
Citation: Katz DA, Tang F, Faseru B, Horwitz PA, Jones P, Spertus J. Prevalence and correlates of smoking cessation pharmacotherapy in hospitalized smokers with acute myocardial infarction. Am Heart J. 2011;162:74-80.
NEW RISK PREDICTION ALGORITHM MAY ESTIMATE INDIVIDUAL PATIENTS’ RISK OF VENOUSTHROMBOEMBOLISM
Prospective cohort study from the U.K. derived and validated the QThrombosis algorithm (www.qthrombosis.org) to predict risk of thrombosis at one and five years, and may be used to start prophylaxis by identifying high-risk patients.
Citation: Hippisley-Cox J, Coupland C. Development and validation of risk prediction algorithm (QThrombosis) to estimate future risk of venous thromboembolism: prospective cohort study. Br Med J. 2011;343:d4656.
ABSOLUTE NEUTROPHIL COUNT PREDICTS SPONTANEOUS BACTERIAL PLEURITIS
Retrospective study of 41 patients showed that almost all patients with hepatic hydrothorax had ascites detectable by ultrasound, and high absolute neutrophil count in pleural fluid was suggestive of spontaneous bacterial pleuritis.
Citation: Gurung P, Goldblatt M, Huggins JT, Doelken P, Nietert PJ, Sahn SA. Pleural fluid analysis and radiographic, sonographic, and echocardiographic characteristics of hepatic hydrothorax. Chest. 2011;140:448-453.