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Affecting virtually every aspect of our health care system, the stunning growth and rapid integration of hospital-based medicine has affected the practice of both medicine and surgery by significantly modifying the delivery of inpatient, outpatient, and subacute care. This article details the history of hospitalists in the United States by defining the practice of hospital medicine and reviewing the evidence extolling its virtues. Although hospital medicine appears here to stay, work must still be done to address a number of current and future issues facing hospitalists and the health care community embracing them.
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Difficulties in Diagnosing Intestinal TB; Can Human Betaretroviruses Trigger Autoimmune Disease?; Rifampin and Pyrazinamide No Longer Recommended for Latent TB; Meningitis in Children with Cochlear Implants
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Randomized trial data suggest that linezolid is superior to vancomycin in the treatment of nosocomial MRSA pneumonia.
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Experiments suggest that bacteria may persist within bladder epithelial cells in a biofilm contained within pods, thus accounting for bacterial persistence manifested as chronic or recurrent urinary tract infection.
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Another study has shown an increase in mortality associated with the use of an oral IIb/IIIa receptor antagonist.
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Four patients treated with levofloxacin for pneumococcal pneumonia had one or more relapses with levofloxacin-resistant isolates. In 5 of 6 relapses, the infecting strain was identical to the initial levofloxacin-susceptible strain by DNA typing.
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The chimpanzee simian immunodeficiency virus, the virus from which HIV-1 originated, arose as the result of recombination between retroviruses of 2 smaller primates that may serve as a food source for the chimp.
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A study of children with perinatally acquired hepatitis C infection followed for an average of 4.8 years showed persistent HCV infection in 81%, with liver disease that was mild. HCV genotype 3 was associated with a higher rate of loss of HCV RNA and normalization of ALT by 30 months of age.