Hospital Medicine Alert
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Acetazolamide in Mechanically Ventilated Patients with COPD: Is There a Benefit?
Compared to placebo, the use of acetazolamide in mechanically ventilated patients with COPD does not significantly reduce the duration of mechanical ventilation. -
New Analysis of COGENT Data Supports Proton Pump Inhibitor Benefit with Low and High Aspirin Doses
A dedicated analysis of the COGENT trial involving coronary artery disease patients on dual antiplatelet therapy shows comparable risks of gastrointestinal and cardiovascular events between low- and high-dose aspirin, and similar benefits of prophylactic proton pump inhibitor therapy. -
Communication Facilitators Potentially Can Improve Care for the Sickest ICU Patients
Highly trained communication facilitators who counseled families and met with physicians and nurses were shown to decrease symptoms of depression in family members at six months and decreased ICU length of stay without affecting mortality. -
Rivaroxaban in the Real World
A large Phase IV registry study shows that rivaroxaban is associated with a very low incidence of major bleeding, death, or stroke. Also, adherence to therapy was much higher than observed in other studies with vitamin K antagonists. -
Delaying Intubation in Severe Alcohol Withdrawal
Delaying intubation until aspiration or cardiopulmonary decompensation did not affect mortality but increased the incidence of pneumonia and length of stay. -
Cardiovascular Events Associated with Masked Hypertension and White-coat Hypertension
Analysis from the Dallas Heart Study consisting of 3027 adults revealed that both white-coat hypertension and masked hypertension were independently associated with increased cardiovascular events, and, therefore, home blood pressure monitoring is recommended for U.S. adults, whether symptomatic or asymptomatic.
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ICH May Clinically Mimic TIA
In a large retrospective review of 2137 patients with intracerebral hemorrhage, 34 had transient symptoms that could have been misclassified as “transient ischemic attack” if brain imaging had not been performed.
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Is Anticoagulant Bridging Needed in Patients with Atrial Fibrillation Going to Surgery?
In patients with atrial fibrillation who had warfarin treatment interrupted for an elective operation or other elective invasive procedure, forgoing bridging anticoagulation was not inferior to perioperative bridging with low molecular weight heparin for the prevention of arterial thromboembolism and decreased the risk of major bleeding.
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Postoperative Atrial Fibrillation Management — You Can’t Go Wrong
Rate control and rhythm control strategies for cardiac surgery patients with postoperative atrial fibrillation lead to similar hospital durations, similar complication rates, and similar very low rates of atrial fibrillation at 60-day follow-up.
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One Quarter of General Medicine Readmissions May Be Preventable
The major concept behind the effort to reduce 30-day readmission rates is the impression that some readmissions are preventable and some are not preventable.