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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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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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Based on their review of prior published studies of telemedicine ICUs and the initiation of a telemedicine ICU in a Veterans Health Administration hospital system, the authors find that costs of implementation are substantial and the sum impact on hospital expenses and profits remains unclear.
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The risk of interrupting prophylactic warfarin for stroke prevention in atrial fibrillation (AF) patients is unclear. Thus, these investigators from Denmark evaluated their national health registry and found 102,591 patients > age 30 with a first-time hospitalization for AF between 1997 and 2008.
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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).
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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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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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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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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.
