Hospital Medicine Alert
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Steroids Increase the Risk for Community-acquired Staphylococcus aureus Bacteremia
Staphylococcus aureus bacteremia continues to cause significant morbidity and mortality. Previous studies produced conflicting results about whether steroids increase the risk of SAB and may have been biased by confounding variables. Therefore, Smit and colleagues sought to more clearly define the risk of SAB associated with the use of steroids.
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Individualized Integrative Medicine Treatment for Preoperative Anxiety
In a randomized, clinical trial investigating the treatment of preoperative anxiety, standard sedating medication with a specified add-on individualized integrative technique is the most effective intervention.
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How Good Is Passive Leg Raise at Predicting Fluid Responsiveness?
SYNOPSIS: In a meta-analysis of 23 clinical trials, passive leg raise was shown to be an excellent predictor of fluid responsiveness.
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In Patients with Intracerebral Hemorrhage, Intensive Lowering of Blood Pressure Does Not Improve Outcome
After spontaneous intracerebral hemorrhage, there is a severe hypertensive response that may be associated with hematoma expansion and increased mortality. The INERACT-2 study (N Engl J Med 2013;368:2355-2365) looked at the effectiveness of blood pressure reduction within six hours after symptom onset, to a target systolic blood pressure of < 140 mmHg.
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Screening for C. difficile Carriers at Hospital Admission Reduces Subsequent CDI
Hospital patients were screened for C. difficile. Contact isolation led to a significant decrease in hospital-acquired C. difficile infections.
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Cerebral Microbleeds: Risk Factor for Symptomatic Intracerebral Hemorrhage
Cerebral microbleeds (CMBs), as visualized on gradient-echo or susceptibility-weighted MRI, are considered markers of bleeding-prone cerebral microvessels and constitute a significant and independent predictor of future intracerebral hemorrhage. -
Buprenorphine Implant for Subdermal Administration (Probuphine)
The FDA has approved the first buprenorphine implant for the treatment of opioid dependence. Buprenorphine is a partial agonist at the mu-opioid receptor and an antagonist at the kappa-opioid receptor. Buprenorphine was previously approved as oral and sublingual tablets. The implant is marketed as Probuphine.
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Human Adenovirus B7: Severe Infection
ABSTRACT & COMMENTARY: Patients with HAdV-B7 were more likely to be adults and to have longer hospital stays.
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Dual Antiplatelet Therapy Appears More Effective Than Single Therapy
The CHANCE study showed that the combination of aspirin and clopidogrel was superior to aspirin alone for reducing the risk of stroke in the first 90 days after a TIA or minor ischemic stroke (N Engl J Med 2013;369:11-19). -
Can Procalcitonin Predict Need for ICU Admission in Community-acquired Pneumonia Patients?
Several studies have focused on the use of procalcitonin in diagnosing sepsis, as a prognostic marker in sepsis, and as a guide to antibiotic decisions in sepsis.