Hospital Medicine Alert – May 1, 2010
May 1, 2010
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Can We Accurately Predict Fluid Responsiveness?
This non-randomized, prospective trial demonstrated that passive leg raising can be used to predict fluid responsiveness in non-intubated, spontaneously breathing patients with severe sepsis or acute pancreatitis. -
NT-pro BNP
Natriuretic peptide levels (BNP, NT-proBNP) are of prognostic value in general populations, but whether they add information to other known risk factors for cardiovascular outcomes is less clear. -
Fusobacterium and Tonsillar Infections
In this study, 847 patients with peritonsillar abscess (PTA) admitted to Aarhus University hospitals from 2001-2006 were included in this retrospective study. -
Colistin and Acute Respiratory Failure
Colistin, a 50-year-old polymyxin antibiotic that recently has been reintroduced to treat multidrug-resistant hospital-acquired Acinetobacter or Pseudomonas pneumonia, can cause acute neuromuscular weakness and precipitate acute hypercapnic respiratory failure, as illustrated by this case report. -
STEMI Patients with Multi-vessel Disease — Culprit- vessel PCI vs. Multi-vessel PCI
Patients presenting with ST-segment elevation myocardial infarction (STEMI) often have co-existing lesions in the non-infarct arteries (i.e., they have multi-vessel disease). These patients present a management dilemma. -
Infection in HIV Patients
In a prospective surveillance study, 50 HIV-positive patients who presented with febrile respiratory symptoms were evaluated for the presence of respiratory viruses by multiplex RT-PCR and a microarray assay and for atypical bacterial pathogens by PCR, in addition to sputum cultures and serologic testing. Viruses accounted for 64% of the infections. Influenza virus was identified in 22 cases, and human metapneumovirus (hMPV) was next most common, with six cases. -
Supplement: Health Care Reform Update
Health care clinicians and organizations likely will find that the new health care reform bill's positive features outweigh its drawbacks, experts say.