Cardiology
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Early Extubation to Noninvasive Ventilation Does Not Reduce Time to Liberation From All Mechanical Ventilation
In this multicenter, randomized, open-label trial of patients who failed a spontaneous breathing trial, those who were extubated to noninvasive ventilation did not have a shorter time to liberation from any form of mechanical ventilation compared to those who were randomized to protocolized standard weaning.
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Thiamine for Septic Shock: Is There a Benefit?
Based on a retrospective review, septic shock patients who were administered thiamine within 24 hours of admission showed improved lactate clearance and reduced 28-day mortality.
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Liberal Oxygen Therapy in the ICU: Time to Change Practice?
Over the last decade, more clinical studies have shown adverse effects of hyperoxia in different patient populations and its association with increased mortality. In a meta-analysis, investigators synthesized data from 25 randomized, controlled trials comparing a liberal oxygen approach to a conservative approach. They included thousands of patients with sepsis, critical illness, stroke, trauma, myocardial infarction, cardiac arrest, and emergency surgery. The authors found that liberal oxygen therapy was associated with increased in-hospital mortality, 30-day mortality, and mortality at longest follow-up. Read on to learn more details about specific subgroups relevant to ICU practice and to see a review of the current data on oxygen therapy in these patients.
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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?
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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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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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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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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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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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The Mediterranean Diet and Cognitive Function: Keep the Mind Sharp
Italian seniors who ate a high-quality Mediterranean diet had better cognitive function than those who did not.