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Noninferiority of Seven vs. 14 Days of Antibiotic Therapy for Bloodstream Infections
In this multinational, noninferiority trial that included more than 3,600 hospitalized patients with bloodstream infections from various pathogens and infectious syndromes, seven days of antibiotic therapy was noninferior to 14 days with respect to death from any cause by 90 days. Patients were excluded if they had severe immunosuppression or foci requiring prolonged treatment, or if their blood cultures yielded Staphylococcus aureus or possible contaminants. Various secondary outcomes were similar between the two groups.
Procalcitonin-Guided Care Leads to Shorter Duration of Antibiotics in Sepsis
In this multicenter, intervention-concealed, randomized clinical trial of 2,760 critically ill patients hospitalized with sepsis, the use of a daily procalcitonin-guided protocol resulted in shorter antibiotic duration as compared with standard care, without a significant difference in 28-day all-cause mortality. There was no significant difference in antibiotic duration between patients managed with a daily C-reactive protein-guided protocol and standard care, and the difference in all-cause mortality between these two groups was inconclusive.
Migraine and Ischemic Vascular Disease: The Search for the Missing Link
The presence of traditional vascular risk factors does not explain the increased incidence of ischemic stroke and myocardial infarction in patients with migraine. The use of nonsteroidal anti-inflammatory drugs does not increase the risk of ischemic stroke or myocardial infarction in migraineurs.
Combustible vs. Electronic Cigarettes Post-PCI
A large, nationwide South Korean study of smokers undergoing percutaneous coronary intervention (PCI) has shown that electronic cigarette use and smoking cessation resulted in similarly lower subsequent major adverse cardiac events compared to continued smoking.
Modifiable Cardiovascular Risk Factors and Late-Life Brain Health
The major modifiable risk factors for cardiovascular diseases are delineated in Life’s Essential 8 (LE8), developed by the American Heart Association. These risk factors are blood pressure, glucose, cholesterol, body mass index, smoking, physical activity, diet, and sleep duration. The investigators in this analysis of two large databases in the United Kingdom and the United States demonstrated that cardiovascular health, as defined by the LE8, will also predict brain health later in life.
OCR Ransomware Settlements Focus on Risk Analysis Failures
The Office of Civil Rights recently announced the ninth settlement to resolve an investigation of a ransomware
HHS Proposal Attempts to Boost Tech Improvements for HIPAA
Health and Human Services recently issued proposed updates to the HIPAA Security Rule to address continuing cybersecurity threats in healthcare, urging covered entities to keep up with the bad guys by adopting the most up-to-date technology.
Court Rules Hospital Not Liable for Negligence Under Ostensible Agency Theory
The California Court of Appeal for the Fifth District affirmed a trial court’s decision granting summary judgment in favor of a hospital in a medical malpractice case.
Neurosurgeon Found Not Negligent in Emergency Surgery Delay Case
The California Court of Appeal for the Second District upheld a trial court’s ruling in favor of a neurosurgeon accused of medical negligence in a case involving a delayed emergency surgery.
AI May Help with EM Handoff Notes
Recent research suggests large language models, a form of artificial intelligence, may be useful in improving the quality of emergency medicine handoff notes, but it also illustrated shortcomings of the current technology.