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A critically ill patient, who was a heroin user, was admitted to a hospital in Scotland in December 2009 and was found to be infected with Bacillus anthracis.
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This meta-analysis casts serious doubt on the ability of rapid response teams to significantly reduce hospital mortality.
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The etiology of blood culture-negative endocarditis was identified in 62.7% of 759 patients using combinations of serological, molecular, and histopathological assays. The majority of the agents not detected by conventional cultures were Coxiella burnetii (30%) and Bartonella spp. (11%), both diagnosed using serological tests, and Trophyrema whipplei, other unusual bacteria, and fungi making up the remainder. For 14% of patients, diagnosis required PCR testing on valve tissue removed during surgery (not in paraffin). The cause of disease could not be determined for 264 patients; 2% of patients had non-infectious endocarditis.
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There is no difference in rates of treatment failure, death, or readmission for COPD between patients treated with oral or intravenous steroids for exacerbation of COPD, but the IV route may be associated with increased cost and length of stay.
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In this before-and-after study of more than 275,000 patients admitted to a Swedish hospital before-and-after implementation of a medical emergency team, in-hospital cardiac arrests decreased and overall in-hospital mortality fell by 10% in the two years following the team's implementation.
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Autochthonous transmission of dengue virus infection has been detected in Florida.
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Early antibiotic administration was associated with reduced likelihood of death, mechanical ventilation, and readmission (but increased risk of Clostridium difficile infection) among patients hospitalized for acute exacerbations of COPD.
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Serious infections caused by Acinetobacter baumannii are appearing in the community, spread by patients who acquired the organism in the hospital setting, and conversely, the organism is being introduced into the hospital from long-term nursing care patient settings. Resistance to antimicrobial agents has increased over the six-year study period, along with the severity of disease.
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The use of angiotensin converting enzyme (ACE) inhibitors in all acute myocardial infarction (MI) patients is controversial. Thus, these investigators from the Register of Information and Knowledge about Swedish Heart Intensive Care Admissions (RIKS-HIA) examined the association between ACE inhibitor therapy and mortality in unselected patients with acute MI.
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In this retrospective study of patients hospitalized because of severe chronic liver disease, venous thromboembolism was relatively common and "auto-anticoagulation" in the form of an elevated INR had no apparent protective effect.
