Illustration by David Rosenman
Newman's Notions | July 2, 2025 | FREE
Most ACP Hospitalist content is available exclusively to ACP Members. This article is free to the public.

Smokey

A patient's chest X-ray made him unforgettable.

Catheter ablation beat medications, cardioversion, lifestyle for afib in recent studies

A recent trial compared catheter ablation to lifestyle modification plus rate and/or rhythm medications in patients with atrial fibrillation and obesity, while a meta-analysis compiled trials that compared catheter or surgical ablation to other interventions for atrial fibrillation.

Critically ill AMI patients who got morphine had higher mortality, study finds

A retrospective analysis of patients in the ICU after an acute myocardial infarction (AMI) found that receipt of opioids in general was associated with mortality, but after adjustment, the link was isolated to morphine specifically.

Early invasive strategy doesn't improve mortality in older adults with ACS, review finds

In older patients with acute coronary syndrome (ACS), an early invasive strategy was associated with lower risk of recurrent myocardial infarction and repeated coronary revascularization but increased risk of major bleeding compared to a conservative strategy, a meta-analysis concluded.

SNRIs associated with improved outcomes from Takotsubo cardiomyopathy

Patients who were on serotonin–norepinephrine reuptake inhibitors (SNRIs) and developed Takotsubo cardiomyopathy were less likely to die at seven days and one year, a propensity-matched cohort study found.

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Photo courtesy of Dr Huo

Medetomidine complicates fentanyl withdrawal

Physicians may be familiar with the drug dexmedetomidine from ICU care. An expert explains how to handle its growing presence in street drugs.

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Between discharge and the next stop

A clinician team took over postdischarge lab follow-up and nonurgent imaging.

Low score on LKA associated with higher patient mortality, ABIM study finds

An analysis of hospitalists participating in the American Board of Internal Medicine (ABIM) Longitudinal Knowledge Assessment (LKA) found that those with scores in the bottom quartile had more patients who died or were readmitted within seven days than those who scored higher.

Early anti-enterococcal empirical therapy may not improve survival in BSI

Having more comorbid conditions or an enterococcal bloodstream infection (BSI) without an identified source independently predicted 14- and 30-day mortality, but receiving early empiric therapy did not, according to a retrospective cohort study in Italy and Spain.

Most septic shock patients had AKI at admission, later recovered kidney function

Having stage 1 acute kidney injury (AKI) was not associated with any increase in mortality risk for septic shock patients, but having stage 2 or 3 AKI did increase risk, a retrospective study found. The kidneys fully recovered in 88.2%, 78.5%, and 63.2% of patients with stage 1, 2, and 3 AKI, respectively.

No difference in mortality, readmission risk with lactated Ringer's vs. normal saline

In an open-label trial, seven Canadian hospitals used lactated Ringer's solution for 12 weeks and seven used normal saline. Then they switched. Patient outcomes didn't vary significantly by which fluid was used.

Fend off pain, delirium, and future fractures

Optimizing hip fracture management can improve outcomes from this common cause of hospitalization, an expert at the American Geriatrics Society's annual meeting explained.

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Brief Case | June 18, 2025 | FREE
Most ACP Hospitalist content is available exclusively to ACP Members. This article is free to the public.

Cases from Main Line Health Lankenau Medical Center

Methemoglobinemia, heart failure, pseudogout, and other diagnoses.


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