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Patients who present with acute myocardial infarction (MI) complicated by cardiogenic shock represent a group at high risk for early mortality. Current guidelines recommend the use of intra-aortic balloon pump (IABP) for these patients, but there are few randomized, controlled trial data to support this.
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Two men presented to a hospital in northwestern Missouri in June 2009 with fever, fatigue, diarrhea, thrombocytopenia and leukopenia. Both had a history of frequent recent tick bites. A novel phlebovirus was isolated in cell culture from patient blood. Electron microscopy revealed virus particles consistent with Bunyaviridae. Sequencing identified the viruses as novel members of the phlebovirus genus.
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Small subcortical brain infarcts, known as lacunar strokes, account for about 25% of all ischemic strokes.
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A historical cohort study from San Francisco General Hospital evaluated patients ≥18 years old that were hospitalized and received at least one dose of ceftriaxone. In a multivariable analysis, for every day a patient also received doxycycline the rate of Clostridium difficile infection was 27% lower than for those who did not receive doxycycline (hazard ratio, 0.73%; 95% confidence interval, 0.56-0.96).
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In this study in which all patients with clinically suspected ventilator-associated pneumonia were given prompt empiric antibiotic therapy, whether that therapy turned out to be appropriate for the organisms recovered turned out to be an important determinant of patient outcomes.
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This article provides many excellent suggestions and strategies for improving communication among the members of the critical care team to reduce medical errors.
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The increasing prevalence of antibiotic resistance in urinary pathogens has led Hooton and colleagues to examine the efficacy of a relatively broad spectrum orally administered cephalosporin in the treatment of uncomplicated cystitis.
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Interpret the rhythm strip shown above. The widened beats on the tracing are not ventricular. What else might they be?
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Patients with preterm contractions, who subsequently were diagnosed to have false labor and discharged, do not have an increased risk for early preterm birth, neonatal mortality, or lower Apgar scores. However, they do have a slightly greater chance of delivering in the late preterm period (34 to 36 weeks).