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Hospital Medicine Alert

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Articles

  • Aortic Stenosis — When to Operate

    Even if asymptomatic, early elective aortic valve replacement should be considered for increasingly symptomatic patients with severe aortic valve stenosis because they have a poor prognosis with a high event rate and a risk of rapid functional deterioration, especially if the peak aortic jet velocity is above 5.5 m/sec.
  • Brain Attack

    Each year, about 795,000 strokes occur in the United States; 85% of these are acute ischemic strokes.
  • Stress Cardiomyopathy

    Stress-induced apical cardiomyopathy (tako-Tsubo) is a recently recognized reversible form of acute cardiomyopathy that may mimic acute myocardial infarction initially.
  • Cardiac Surgery in Nonagenarians

    Cardiac surgery carries greater risk in older patients. Nonagenarians are a growing part of cardiology practice as our population ages. While age > 90 years has previously been considered a contraindication to cardiac surgery, more recently, surgeons have been operating on selected nonagenarians who have high functional status.
  • Early Goal-directed Therapy for Sepsis

    One-year mortality post-severe sepsis and septic shock was significantly reduced after implementation of an early goal-directed therapy protocol for sepsis in a large urban emergency department.
  • To Prone or not to Prone ... That Is the Question

    This multicenter, unblinded, randomized trial demonstrated that prone positioning was not associated with a mortality benefit in patients with ARDS, including subgroups with moderate and severe hypoxemia.
  • Drug Compliance and Persistence — A Major Public Health Problem

    Patients who adhered to prescribed anti-hypertensive medication experienced a significantly decreased risk of acute cardiovascular events, yet only 6 months after diagnosis, only 8.1% of patients were classified as having high adherence, 40.5% demonstrated intermediate adherence, and 51.4% demonstrated low adherence to prescribed medication regimens.
  • Clostridium difficile Diarrheal Disease in Children

    Do children < 1-year-old actually develop diarrhea due to C. difficile? What should be the patient age cutoff below which laboratories should reject any stools for C. difficile testing? How will the new state-of-the-art molecular tests influence the interpretation of results in children?
  • Noncardiac Surgery in Patients with Coronary Stents

    Percutaneous coronary intervention (PCI) with bare-metal stents (BMS) or drug-eluting stents (DES) remains the most common method of coronary revascularization.
  • Influenza H1N1 Can Hurt Muscles Bad

    It has been known for decades that influenza viruses have a propensity to affect muscle. Muscle aches from mild to severe occur regularly with the acute attack of the virus.