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The risk of relapse after effective therapy with plasma exchange for thrombotic thrombocytopenic purpura (TTP) has not been well-characterized. Among 376 patients with an initial episode of TTP treated with plasma exchange, overall survival was around 68%, with a survival of 78% among the subset with idiopathic TTP. Survival did not differ on those having a low (< 10%) ADAMTS13 level. Relapse was greater for those with a low ADAMTS13 level at the time of presentation.
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In this large retrospective cohort study of more than 100,000 patients in 112 hospitals, after correction for illness severity and other factors, daily rounds by a multidisciplinary care team were associated with lower mortality in the ICU, regardless of whether an intensivist model of physician staffing was in use.
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Colistin, a 50-year-old polymyxin antibiotic that recently has been reintroduced to treat multidrug-resistant hospital-acquired Acinetobacter or Pseudomonas pneumonia, can cause acute neuromuscular weakness and precipitate acute hypercapnic respiratory failure, as illustrated by this case report.
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This non-randomized, prospective trial demonstrated that passive leg raising can be used to predict fluid responsiveness in non-intubated, spontaneously breathing patients with severe sepsis or acute pancreatitis.
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Natriuretic peptide levels (BNP, NT-proBNP) are of prognostic value in general populations, but whether they add information to other known risk factors for cardiovascular outcomes is less clear.
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In this study, 847 patients with peritonsillar abscess (PTA) admitted to Aarhus University hospitals from 2001-2006 were included in this retrospective study.
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Patients presenting with ST-segment elevation myocardial infarction (STEMI) often have co-existing lesions in the non-infarct arteries (i.e., they have multi-vessel disease). These patients present a management dilemma.
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In a prospective surveillance study, 50 HIV-positive patients who presented with febrile respiratory symptoms were evaluated for the presence of respiratory viruses by multiplex RT-PCR and a microarray assay and for atypical bacterial pathogens by PCR, in addition to sputum cultures and serologic testing. Viruses accounted for 64% of the infections. Influenza virus was identified in 22 cases, and human metapneumovirus (hMPV) was next most common, with six cases.
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Health care clinicians and organizations likely will find that the new health care reform bill's positive features outweigh its drawbacks, experts say.
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In this prospective, multicenter, randomized trial, addition of a helium-oxygen gas mixture to non-invasive positive pressure ventilation in the treatment of COPD exacerbations did not decrease the need for intubation when compared to non-invasive positive pressure ventilation alone.
