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Ischemic stroke remains a leading cause of death worldwide, and atrial fibrillation is a major risk factor, increasing the risk of ischemic stroke five-fold in those who have a confirmed diagnosis of atrial fibrillation.
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This study demonstrated an association between increased discontinuity of physician care in the inpatient setting and increased hospital costs at a tertiary care center.
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Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia and has been the leading arrhythmic cause for hospitalization. With an increasing trend toward outpatient care of subacute illness, it is possible that the AF hospitalization rate is stable or decreasing despite the aging population.
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Percutaneous gastrostomy (PEG) and jejunostomy (J) tubes are utilized in hospital practice for medical or surgical patients in whom oral nutrition is either inadequate to meet caloric needs or unsafe as a result of structural or functional abnormality.
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This single-center, randomized controlled trial demonstrated that intensive insulin therapy targeting blood glucose values of 80-110 mg/dL does not improve mortality, but does increase the incidence of hypoglycemia in a group of critically ill medical and surgical patients.
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Through a retrospective analysis, this study examined ICU resource use and costs for 121,747,260 inpatient hospitalizations, and found a rapid rise in Medicare ICU use with stable adjusted daily critical care costs, but increasing costs for care outside the ICU.
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A quality improvement intervention aimed at improving palliative care in the ICU resulted in improvements of nurse-assessed quality of dying and a reduction in ICU length of stay, but no changes in family perceptions of quality of dying or satisfaction with care.
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Khan et al report a multicenter trial comparing pulmonary vein isolation vs AV junctional ablation with biventricular pacing in patients with atrial fibrillation and heart failure.
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The risk of recurrent venous thromboembolism (VTE) during extended anticoagulant therapy for thrombophilia remains poorly defined. Investigators analyzed 661 patients with idiopathic VTE who had been randomized to extended prophylaxis after three months of initial anticoagulation using either low-intensity (INR 1.5-1.9) or standard-intensity (INR 2.0-3.0) anticoagulation. Thrombophilic defects were identified in 42% of patients. The rate of recurrent VTE of only 0.9% per patient year was not influenced by thrombophilic abnormalities. Antiphospholipid antibodies trended toward increased recurrence (HR, 2.9; 95% CI: 0.9-10.5). The presence of thrombophilic defects did not increase the risk of recurrent VTE during extended anticoagulation relative to patients with idiopathic VTE without thrombophilic defects.
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Recombinant Panton-Valentine leukocidin (PVL) toxins showed lytic activity against human (but not murine) neutrophils. The lytic activity of culture supernatants of USA400 and USA300 strains of MRSA were completely neutralized by anti-PVL monoclonal antibodies. In contrast, phenol-soluble modulin alpha3 (PSM) failed to lyse human neutrophils but did enhance PVL-mediated neutrophil lysis.
