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When a day care worker reported to employee health at Dartmouth-Hitchcock Medical Center in Lebanon, NH, with a severe, spasmatic cough that had lasted more than two weeks, an employee health nurse immediately thought of pertussis.
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Tuberculosis has been reduced to record lows in the United States since the major hospital outbreaks in the 1980s and '90s, but there is growing concern that deadly strains of extensively drug-resistant (XDR) TB may arise at a point of U.S. disinterest and waning funding, the very trough of the so-called "U-shaped curve of concern" that historically precedes TB resurgence.
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The emergence of extensively drug-resistant tuberculosis (XDR-TB) has joined with the aftershocks of SARS and the threat of pandemic flu to put respiratory protection issues for health care workers back on the front burner.
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One of the harsh lessons of the "unforgiving" outbreak of severe acute respiratory syndrome (SARS) in Toronto was the infectious risk of the undiagnosed patient. While much has been made of the respiratory protection issues and fit-testing of N95 respirators, almost three-quarters of the health care workers infected in the 2003 Toronto outbreak were treating patients who had not been diagnosed with the emerging infection, said Allison McGeer, MD, infectious disease consultant at Mount Sinai Hospital in Toronto.
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Compared with a lower dose, intensive treatment with atorvastatin in patients with stable coronary disease significantly reduces hospitalizations for HF.
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Obesity and the magnitude of nocturnal oxygen desaturation, which is an important pathophysiological consequence of OSA, are independent risk factors for incident AF in individuals <65 years of age.
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Elimination of daily routine CXRs reduced the number of CXRs in a mixed medical-surgical ICU, while not affecting readmission rate and ICU and hospital mortality rates.
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Current AP schedules do not appear to prevent catheter-related thrombosis. Systemic VTE and mortality, however, appeared lower after prophylaxis.
