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Prilosec and Nexium Cleared; Anastrozole over Tamoxifen for Breast Cancer; Antibiotics and Steroids Not for Sinusitis; FDA Actions
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In an attempt to enhance what it considered a sluggish nationwide response to the Institute of Medicine's calls for reducing error and improving patient outcomes in hospital care, the Institute for Healthcare Improvement (IHI) initiated in 2004 an ambitious, highly visible, 18-month program.
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Multiple recent studies have demonstrated that red blood cell (RBC) transfusion may be deleterious to critically ill patients, as it has been found to be associated with increased mortality following coronary artery bypass surgery, increased rates of ventilator-associated pneumonia and worse outcomes in patients with burn injury and trauma.
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De Jong and colleagues in The Netherlands conducted a prospective, randomized, double-blind, double-dummy, placebo-controlled, parallel-group clinical study of intravenous vs oral corticosteroids in the treatment of patients hospitalized because of an exacerbation of chronic obstructive pulmonary disease (COPD).
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Previous work demonstrates that selective gut decontamination decreases the risk of ventilator-associated pneumonia (VAP), but the practice has been limited by concerns about promoting antibiotic resistance.
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In this issue: FDA warnings for existing drugs dominate pharmaceutical news this month.
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This article points out the disadvantages of partial DNR ordersfor both clinicians and patientsand offers clear steps for mitigating the problem by developing a supplemental patient care plan for patients who are less than full code.
