Hospital Medicine Alert – January 1, 2007
January 1, 2007
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Nitazoxanide for the Treatment of Clostridium difficile Colitis
Clostridium difficile diarrhea and colitis have now emerged as common nosocomial infections in hospitals throughout the developed world. Alarmingly, recent epidemiological studies in ambulatory settings have documented C. difficile infection in both adults and children who lack the usual risk factors of prior antibiotic use or hospitalization. -
Keeping HIT on Our Radar Screens
A meta-analysis of 10 studies of heparin used either for prophylaxis or for treatment suggests that venous thromboembolism related to heparin-induced thrombocytopenia occurs frequently in patients previously treated with unfractionated heparin, but uncommonly in those on low molecular weight heparin. -
Severe Symptomatic Carotid Artery Stenosis — Endarterectomy or Stenting?
The stroke and death rates at one and 6 months were lower in patients with symptomatic carotid stenosis (> 60%) treated with endarterectomy versus stenting. -
Magnesium Sulfate Tocolysis
Given its lack of benefit, possible harms, and expense, magnesium sulfate should not be used for tocolysis. -
First-Line Treatment for Atrial Flutter in the Elderly: Ablation
RFA should be considered a first-line therapy even after the first episode of symptomatic AFL. There is a better long-term success rate, the same risk of subsequent AF, and fewer secondary effects. -
Statins for Heart Failure
Among adults diagnosed with heart failure who had no prior statin use, incident statin use was independently associated with lower risks of death and hospitalization among patients with or without coronary heart disease.