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Early Rehospitalization Among ICU Survivors: How Can We Do Better?
Based on inductive analysis of a large sample of patients and caregivers, this study provides an organizational framework on which to focus efforts to develop complex healthcare interventions aimed at reducing readmission after critical illness.
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Diagnosis Sepsis: Is Newer Better?
Sepsis-3 criteria may be the favored method for prognostication, whereas SIRS-based criteria may be the preferred method to screen patients for consideration of ICU admission. Future studies are necessary to continue to explore the benefits of qSOFA and potentially reveal a more precise and reliable screening tool. Most importantly, it is paramount to remember that neither set of criteria is diagnostic. Using clinical judgment along with these guides remains the ideal approach.
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A Combination of Commonly Measured Clinical Variables May Predict Prolonged Mechanical Ventilation
The results of this study validate a clinical tool using common ICU variables for predicting prolonged mechanical ventilation. However, one must consider both the implications and strength of any predictive model for clinical decision-making.
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Antipsychotics Do Not Shorten the Duration of ICU Delirium
These results support minimizing the use of haloperidol and ziprasidone in delirious patients who are not agitated. Current best practice is to adhere to the ABCDE bundle, remove causative agents when possible, and continue antipsychotics (only if they appear effective and for the minimum time necessary). The jury is still out regarding how to manage agitated delirium.
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Acupuncture as Adjunct Therapy for Infertility in Polycystic Ovary Syndrome
Acupuncture as an adjunctive therapy for treating infertility in Chinese women with polycystic ovary syndrome receiving clomiphene citrate or placebo offered no benefit over sham acupuncture.
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Initial Management of Patients With Medication-Overuse Headache
As part of a randomized treatment trial for medication-overuse headache, a simple protocol that provided early advice on stopping excessive medications was effective in one-third of patients, even before any prophylactic medications were started.
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Hormone Therapy and Mortality: No Overall Effect?
An evaluation of outcomes of users and nonusers of postmenopausal hormonal therapy followed longitudinally in the Danish database showed no overall difference in mortality.
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Should the Copper IUD Be Offered to Women With Heavy Menstrual Bleeding?
In this secondary analysis of the Contraceptive CHOICE Project, there was no difference in copper intrauterine device continuation rates at one year between 165 women who reported heavy menstrual bleeding at baseline and 753 women who did not.
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Pediatric Cardiothoracic Point-of-Care Ultrasound: Part I
Ultrasound has emerged as a critical tool for use at the bedside to guide not only diagnosis but treatment strategies as well. The first part of this article focuses on the uses and limitations of cardiac ultrasound in the acute setting. Part II will include discussion of cardiac arrest, congenital abnormalities, pneumothorax, pleural effusion, and pneumonia.
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High Altitude Medicine: A Review for the Practicing Emergency Physician
The recognition and treatment of high altitude illness is within the core content of emergency medicine practice. High altitude illness represents a spectrum of clinical entities, ranging from common and benign acute mountain sickness to life-threatening high altitude pulmonary edema and rare but potentially lethal high altitude cerebral edema.