Background: Revefenacin (REV), a once-daily, long-acting muscarinic antagonist for nebulized inhalation, was recently approved for maintenance treatment of chronic obstructive pulmonary disease (COPD). We present post hoc efficacy and safety data from three phase 3 trials in patients with moderate to very severe COPD by patient subgroup (<65 y, 65–75 y, >75 y). Methods: This [...]

Background: Many patients with chronic obstructive pulmonary disease (COPD) have suboptimal peak inspiratory flow rate (sPIFR) because of lung hyperinflation, hypoxemia, and muscle wasting, preventing effective use of dry powder inhalers commonly used to treat COPD. sPIFR and airflow limitation interaction may be responsible for excess symptoms in patients with COPD. Here we characterize baseline [...]

Background: Atrial fibrillation leads to increased risk of systemic embolism (SE) and stroke. To decrease the occurrence of stroke/SE, anticoagulation is routinely prescribed. Recently, non-vitamin K anticoagulants like apixaban and rivaroxaban have become more popular and are preferred over warfarin. We here compare the efficacy and safety of apixaban with warfarin. Methods: Eligible participants were [...]

Background: The “July effect” is a perceived increased risk of medical errors that occurs when US medical graduates begin residencies. There is substantial variability in results across studies of the “July effect” on patients who are admitted for heart attacks. Furthermore, studies that do show statistically significant increase in mortality at the start of residency [...]

Case Presentation: A 36 year old male from Central America who immigrated to the United States ten years ago presented with cough and headache accompanied with fevers. He did not have any past medical conditions. On admission his vitals were T 39.1 C, HR 114, RR 20, BP 129/85 mmHg. He was noted to have oral [...]