Internal Medicine Alert – January 15, 2019
January 15, 2019
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A Review of Updated Guidelines Regarding Bradycardia and Cardiac Conduction Delay
The American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society have established updated guidelines on the evaluation and management of patients with bradycardia and conduction delays. Many key elements remain largely unchanged from prior guideline recommendations on pacemakers published in 2008 and 2012, but there are important new definitions, recommendations, and areas of emphasis.
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Factors Associated With Urinary Tract Infections Caused by Multidrug-Resistant Gram-Negative Bacteria
The authors of a multicenter, retrospective, cohort study from southern and eastern Europe identified predictive factors for multidrug-resistant complicated urinary tract infections.
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Healthcare-Associated Infections: Better, But Not There Yet
One-day prevalence studies demonstrated that there was a 16% reduction in the risk of healthcare-associated infections from 2011 to 2015.
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Patients Need to Rethink the ‘Quality’ in Healthcare
Increasingly, patient satisfaction is an important and commonly used surrogate marker for healthcare quality. Further, reimbursement to physicians may be based on patient satisfaction as a “quality” metric. But the evidence linking a patient’s subjective sense of satisfaction and the actual delivery of quality care remains tenuous.
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Rifamycin Delayed-Release Tablets (Aemcolo)
Rifamycin is indicated for the treatment of traveler's diarrhea caused by noninvasive strains of Escherichia coli in adults.
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A ‘Detective’ Diagnosis
The ECG in the figure was obtained from a 40-year-old man. Without the benefit of any history, how might one interpret this tracing? Is there evidence of an acute coronary syndrome? Is there a common diagnosis that potentially explains all the findings?