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If infection preventionists can work their way out of the current wilderness of change, there is some feeling they may be poised for a leadership role in a health care system becoming painfully aware of the power of prevention.
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Editor's note: Peter J. Pronovost, MD, PhD is a professor in the departments of anesthesiology and critical care, surgery, and health policy and management at the Johns Hopkins University School of Medicine.
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Increasing the possibility of hospital outbreaks via undiagnosed cases, measles infection has hit the United States at epidemic levels this year. More measles cases were reported in the first seven months of 2008 than during the same period in any year since 1996, according to the Centers for Disease Control and Prevention.
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Back pain is a ubiquitous complaint in the primary care setting. The evaluation and management of these patients varies based on several risk factors for serious disease called the red flags of back pain.
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Some women with DVT may stop warfarin after six months; Vytorin and cancer; preventing recurrent stroke; and FDA news.
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Although anemia was predictive of adverse outcomes in patients with aneurysmal subarachnoid hemorrhage, red blood cell transfusion was also associated with an increased risk of death, severe disability or delayed infarction. These results call into question the practice of liberal transfusion thresholds in patients with spontaneous subarachnoid hemorrhage.
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In spite of institutional education regarding appropriate use of prophylactic antibiotics, compliance was achieved only when hospital protocols that mandated specific antibiotic use were implemented.
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The optimal duration of oral anticoagulation therapy after an initial symptomatic deep venous thrombosis remains unknown. Siragusa et al assessed patients by ultrasonography for the presence of residual vein thrombosis (RVT) after three months of anticoagulation for a DVT. Those with RVT were randomized to 9 additional months of anticoagulation versus discontinuation. Among the 70% with RVT, prolonged anticoagulation showed only a non-significant trend for reducing recurrent DVT. For the 30% without RVT, all of whom stopped anticoagulation after three months, only one of 78 patients (1.3%) developed a recurrent DVT. For select patients, the lack of RVT after initial anticoagulation identifies patients in whom anticoagulation may be safely discontinued. The optimal duration of anticoagulation for higher risk patients, including those with RVT, remains undefined.
