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The risk of relapse after effective therapy with plasma exchange for thrombotic thrombocytopenic purpura (TTP) has not been well-characterized. Among 376 patients with an initial episode of TTP treated with plasma exchange, overall survival was around 68%, with a survival of 78% among the subset with idiopathic TTP. Survival did not differ on those having a low (< 10%) ADAMTS13 level. Relapse was greater for those with a low ADAMTS13 level at the time of presentation.
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In a prospective, observational study, > 50% of patients identified and treated for severe sepsis in the emergency department (ED) had negative cultures; 18% of patients had a noninfectious diagnosis that mimicked sepsis.
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This two-phase, prospective, multicenter study demonstrated that implementation of an intubation management protocol reduced the incidence of severe hypoxemia and cardiovascular collapse during endotracheal intubation when compared to standard practice, but did not improve other patient outcomes such as ICU mortality or duration of mechanical ventilation.
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Although age is a risk factor for morbidity and mortality with cardiac surgery, chronologic age does not always reflect biological age. Although frailty has been shown to predict falls, hospitalization, institutionalization, and mortality in geriatric populations in the community, it has not been systematically studied in patients undergoing surgery.
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Superficial venous thrombosis is not a benign condition and deserves close attention.
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[Editor's note: This article is the first in a two-part series on preventing violence. In this story we examine the keys to a zero tolerance policy. In next month's issue, we will discuss key recommendations from the Occupational Safety and Health Administration and the importance of communicating effectively with patients and their families.]
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EDs at a number of Hospital Corporation of America (HCA) hospitals in the Southeast are using "new media" to inform patients of their average wait times over the past several hours. These times have been posted on hospital web sites, digital billboards, and most recently, via text messaging.
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Human subjects research organizations need a thorough, fair, and effective way of handling complaints and concerns about research trial ethical and regulatory violations.
