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Blockage of the harmful effects of tissue plasminogen activator by imatinib (Gleevec) might improve ischemic stroke outcomes.
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The optimal duration of oral anticoagulation therapy after an initial symptomatic deep venous thrombosis remains unknown. Siragusa et al assessed patients by ultrasonography for the presence of residual vein thrombosis (RVT) after three months of anticoagulation for a DVT. Those with RVT were randomized to 9 additional months of anticoagulation versus discontinuation. Among the 70% with RVT, prolonged anticoagulation showed only a non-significant trend for reducing recurrent DVT. For the 30% without RVT, all of whom stopped anticoagulation after three months, only one of 78 patients (1.3%) developed a recurrent DVT. For select patients, the lack of RVT after initial anticoagulation identifies patients in whom anticoagulation may be safely discontinued. The optimal duration of anticoagulation for higher risk patients, including those with RVT, remains undefined.
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In spite of institutional education regarding appropriate use of prophylactic antibiotics, compliance was achieved only when hospital protocols that mandated specific antibiotic use were implemented.
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Although anemia was predictive of adverse outcomes in patients with aneurysmal subarachnoid hemorrhage, red blood cell transfusion was also associated with an increased risk of death, severe disability or delayed infarction. These results call into question the practice of liberal transfusion thresholds in patients with spontaneous subarachnoid hemorrhage.
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The findings of this retrospective study of 825 patients hospitalized with COPD exacerbations indicate that the use of beta blockers in such patients is not harmful and may actually be associated with reduced mortality.
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The atrial fibrillation and congestive heart Failure (AF-CHF) trial was designed to test the hypothesis that a treatment strategy that involved rhythm control would be superior to rate control in patients with heart failure and left ventricular systolic dysfunction.
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As of early 2008, a minority (about 17%) of physicians have a basic or extensive electronic health record (EHR) system. Those who use electronic health records believe they improve the quality of care, and tend to be primary physicians, those practicing in large groups, hospitals, or medical centers, and those located in the western region of the United States.
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Surrogate decision makers rated communication as good but could not answer questions about resuscitation status or the care their family member was receiving.
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In this study, 750 severely ill patients requiring initial hemodialysis were randomized to receive either jugular or femoral vein catheterization. Jugular catheterization significantly increased the incidence of catheter colonization in patients with body mass index (BMI) < 24.2, whereas jugular catheterization decreased the incidence in patients with BMI > 28.4. Across all BMI strata, there was no significant difference in catheter-related blood stream infections in patients who underwent femoral vs jugular catheterization.
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Ceftobiprole, a novel broad-spectrum cephalosporin with activity against MRSA, was non-inferior to vancomycin plus ceftazidime in a study of complicated skin and skin-structure infections. This is the first β-lactam with reliable activity against methicillin resistant Staphylococcus aureus (MRSA) to be evaluated in advanced-stage clinical trials.
