Hospital Medicine Alert – March 1, 2008
March 1, 2008
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Proactive Palliative Care in the Medical ICU Affects Length of Stay for High-Risk Patients
Using a simple clinical screening tool, patients considered at high risk for death in this closed medical ICU received a basic palliative care consultation. Those with unmet needs received a full consultation with ongoing intervention from the palliative care team. This process shortened ICU length of stay without affecting mortality rates or discharge disposition. -
Transient Ischemic Attacks: A Neurologic Emergency?
Two recent studies suggest that rapid TIA evaluation and treatment can reduce stroke risk. -
Schistosomiasis and Strongyloidiasis in African Refugees
Schistosomiasis and strongyloidiasis were highly prevalent in two cohorts of African refugees resettled to the United States; presumptive treatment for parasitic diseases in such groups should include coverage for these parasitoses. -
Non-HACEK Gram-Negative Bacillus Endocarditis
Of 2761 patients with endocarditis enrolled in a prospective, multinational cohort study, 49 patients with non-HACEK gram-negative endocarditis were identified. E. coli and Pseudomonas aeruginosa were the most common pathogens, and 57% were considered to be health care associated. Fifty-nine percent of cases were associated with prosthetic valves. The mortality rate was high (24%) despite cardiac surgery being performed in 51% of cases. -
Timing of Catheterization in NSTE-ACS
An early invasive approach is preferred for higher risk non-ST elevation acute coronary syndromes (NSTE-ACS), but the optimal timing of cardiac catheterization is not clear.