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The purpose of this meta-analysis was to assess the efficacy of subglottic secretion drainage in preventing ventilator-associated pneumonia (VAP). Dezfulian and colleagues performed a comprehensive analysis of randomized trials that have compared subglottic secretion drainage with a standard endotracheal tube care in mechanically ventilated patients.
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This observational study from a university-affiliated, urban, tertiary hospital in Toledo, OH, retrospectively reviewed the records of 840 patients admitted to various ICUs to determine if the time to first visit by a physician had an effect on a number of clinically relevant outcomes.
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Care of the critically ill pregnant patient poses unique challenges. The normal physiology of a pregnant patient differs considerably from that of a non-pregnant patient and these differences may affect many aspects of routine care: resuscitation, mechanical ventilation, choice of drugs and use of diagnostic studies are some examples.
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The emergency department physician is the critical link between the patient and the diagnostic tests, including radiographs, that are ordered. This article provides information on common radiographic errors to help clinicians improve their accuracy, confidence and subsequent patient care.
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Stopping Aspirin Before Surgery; The Sponge Returns; Preventing Metabolic Syndrome; FDA Actions
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In the absence of definitive systematic reviews, and in the presence of evidence for continued widespread administration of low-dose dopamine infusions to critically ill patients for the purpose of preventing renal failure, Friedrich and colleagues performed an exhaustive review of the literature on this subject.
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The telemetry rhythm strip shown in the Figure was obtained from a 67-year-old woman who presented with heart failure. A permanent pacemaker had been implanted a number of years earlier. Interpret the tracing initially by looking only at lead MCL1. How does the addition of a second simultaneously recorded lead (lead II) help in your interpretation? How many findings can you identify on this two-lead telemetry tracing? (Hint: Some of these findings are very subtle.)
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Neuroleptic malignant syndrome is a disease process usually occurring in patients who use neuroleptic agents; classically, it is characterized by altered mental status, muscular rigidity, fever, and
autonomic instability.
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In this study, investigators conducted a large, international, randomized controlled clinical trial (as a part of the CREATE trial) to determine the effect of glucose-insulin-potassium infusion on mortality in patients presenting with acute ST-segment elevation MI.