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The prevalence of Lyme meningitis among children with nonspecific aseptic meningitis occurring from April through December in the years 2006 through 2009 in an endemic area for Lyme disease was 13.3% (95% confidence interval [CI], 6.3%-25.1%).
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Common specific causes of fever in Finnish returned travelers were Campylobacter, malaria, bacteremia, HIV, and influenza; they included a significant proportion of potentially life-threatening infections, and more than one diagnosis. Evaluation of such fevers should be systematic and thorough.
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In this study of a statewide administrative database, among 138,720 adult patients admitted to an ICU, uninsured patients had a 25% higher likelihood of death within 30 days compared with privately insured patients, differences that persisted after multiple adjustments for demographics, severity of illness, and site of care. Uninsured patients received central venous catheterization, acute hemodialysis, and tracheostomy significantly less often than insured patients.
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A post hoc analysis of patients with bacteremia due to ESBL-producing E.coli (ESBL-EC) from 6 published cohorts was performed. Treatment with B-lactam/B-lactamase inhibitors (BLBI) vs. carbapenems did not show any difference in mortality or length of hospital stay.
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Lead II rhythm strip from a patient with palpitations? What would you do?
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Based on the findings of this meta-analysis of seven randomized controlled trials, early (7 days after intubation) or late (any time after 7 days) tracheostomy placement did not alter clinical outcomes in study patients, including no differences in mortality, incidence of ventilator-associated pneumonia, duration of mechanical ventilation, ICU stay, hospital stay, or sedation.
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In a nationally representative sample of U.S. hospitals, reported routine use of daily interruption of sedation for mechanically ventilated patients was associated with the presence of a leadership emphasis on safety culture, receptivity of the staff to practice change, and participation in a collaborative to prevent health care-associated infections. There was no association with the number of hospital beds or with the presence of a medical school affiliation.
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Venous thromboembolism (VTE) prophylaxis interventions in gynecologic surgery are meritorious, supported by Level 1 evidence and the subject of multiple guidelines, including those published by the American College of Obstetricians and Gynecologists. However, new evidence suggests nearly one-third of women undergoing hysterectomy in this country still receive no VTE prophylaxis, placing thousands of women at unnecessary risk for preventable morbidity.
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Most patients with ST-elevation myocardial infarction (STEMI) present to hospitals that are not capable of percutaneous coronary intervention (PCI).
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An outbreak of dengue fever in northeastern Kenya has recently sickened at least 5,000 people.