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All patients who present to a health care setting with fever and respiratory symptoms should be managed according to the CDCs recommendations for respiratory hygiene and cough etiquette and questioned regarding their recent travel history.
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In a strategy somewhat reminiscent of the state-by-state battle to get needle safety laws enacted, consumer advocates are taking their cry for open hospital infection rate reporting to one legislature at a time. Pennsylvania and Illinois have enacted laws, and bills are under discussion in a variety of other states.
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Shedding of virus after use of live attenuated influenza vaccine (LAIV) in adults occurs the first few days after vaccination, but is minimal by one week after immunization. The data suggest that the recommendations for LAIV use in health care workers could be modified to include separation from patients for, at most, seven days after vaccination, reports Tom Tolbert, MD, MPH, instructor of medicine in the division of infectious diseases at Vanderbilt University Medical Center in Nashville, TN.
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Moving to clear up the considerable confusion of the last flu season, the Centers for Disease Control and Prevention (CDC) has drafted new guidelines for health care workers who receive the live attenuated influenza vaccine (LAIV), Hospital Infection Control has learned. The CDCs Advisory Committee on Immunization Practices (ACIP) is expected to soon release new guidelines that will allow the LAIV nasal spray vaccine to be used more liberally in health care settings with fewer restrictions on immunized workers.
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In this controlled trial from Europe, investigators randomized 940 AMI patients to either GIK (476 patients) or no infusion (464 patients) prior to undergoing reperfusion via percutaneous transluminal coronary angioplasty.
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Studies demonstrate that angiotensin-converting-enzyme (ACE) inhibitors such as captopril reduce mortality and cardiovascular morbidity for patients with myocardial infarction (MI) complicated by left ventricular systolic dysfunction, heart failure, or both. The authors surmised that since angiotensin II can be generated despite ACE inhibition, further efficacy can be obtained if receptor antagonists are combined with ACE inhibitors.
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Trauma to the thoracic cavity is responsible for approximately 10-25%
of all trauma-related deaths, with the majority of these deaths
occurring after arrival at the emergency department. The mortality for
isolated chest injury is relatively low (less than 5%); however, with
multiple organ system involvement, the mortality approaches 30%. This
article dissects the critical aspects of thoracic trauma and highlights
acute care management strategies.
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