Pulmonary

This Clinical Insights discusses the role primary care clinicians have in screening, diagnostic testing, and treatment of patients with obstructive sleep apnea.

Author/s:

Alejandra C. Lastra, Julie M. Neborak, Babak Mokhlesi

Association of Smoking Cessation and Cardiovascular, Cancer, and Respiratory Mortality

Rowan Hutchins — Sat, 09 Dec 2023 06:00:00 +0000

Date Added:

December 9, 2023

Journal/Publication:

JAMA

Publisher:

AMA

Publication Date:

November 27, 2023

URL:

Association of Smoking Cessation and Cardiovascular, Cancer, and Respiratory Mortality

Type:

Clinical Research Results

Format:

Article

DOI (1):

10.1001/jamainternmed.2023.6419

Keywords

PMID (1):

38010645

MeSH

Cardiovascular Risk Factors

Smoking Cessation*

Cigarette Smoking

Pulmonary

Quantification of reductions in adverse outcomes after smoking cessation. James W. Mold, MD, MPH

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There were an estimated 28 million current cigarette smokers in the US, and approximately twice as many former smokers, in 2021.1 Smoking cessation is associated with large reductions in excess mortality compared with continued smoking,2 but the timescale over which cause-specific mortality benefits of cessation may develop is unclear.3-6 Quantifying excess cause-specific mortality among former smokers by years since quitting may inform clinical decision-making and screening programs.

Author/s:

Blake Thomson, Farhad Islami

Preoperative Cardiac Risk Assessment

John Bayhi — Thu, 27 Feb 2020 15:22:21 +0000

Date Added:

February 27, 2020

Journal/Publication:

Mayo Clinic Proceedings

Publisher:

Elsevier B.V. / Mayo Foundation for Medical Education and Research

Publication Date:

February 24, 2020

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1016/j.mayocp.2019.08.013

Keywords

cardiac

preoperative assessment

MeSH

acute coronary syndrome

Cost-Benefit Analysis

This is a review of the latest recommendations regarding the cardiac assessment of patients needing surgery. James W. Mold, MD, MPH

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Major adverse cardiac events are common causes of perioperative mortality and major morbidity. Preventing these complications requires thorough preoperative risk assessment and postoperative monitoring of at-risk patients. Major guidelines recommend assessment based on a validated risk calculator that incorporates patient- and procedure-specific factors. American and European guidelines define when stress testing is needed on the basis of functional capacity assessment. Favoring cost-effectiveness, Canadian guidelines instead recommend obtaining brain natriuretic peptide or N-terminal prohormone of brain natriuretic peptide levels to guide postoperative screening for myocardial injury or infarction. When conditions such as acute coronary syndrome, severe pulmonary hypertension, and decompensated heart failure are identified, nonemergent surgery should be postponed until the condition is appropriately managed. There is an evolving role of biomarkers and myocardial injury after noncardiac surgery to enhance risk stratification, but the effect of interventions guided by these strategies is unclear.

Author/s:

Raslau, D, Bierle, DM, Stephenson, CR, Mikhail, MA, Kebede, EB, Mauck, KF