Internal Medicine
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Prevention of Clostridium difficile Recurrence by Orally Administered Fecal Microbiota Transplantation
Fecal microbiota transplantation orally administered in capsules was non-inferior to administration by colonoscopy.
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Unexpected Benefit of Pneumococcal Vaccine in Decreasing the Burden of Otitis Media
Surveillance data collected prospectively in Israel reveal a decline in progression from pneumococcal carriage to complex otitis media in both vaccine-targeted and non-vaccine serotypes following implementation of routine use of pneumococcal conjugate vaccines. Vaccinating against pneumococcal serotypes causing early-life infections may reduce the risk of subsequently developing complex otitis media due to other organisms.
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Follow-up Blood Cultures in Gram-negative Bacteremia — Don’t Order Them
In contrast to blood cultures obtained on therapy in patients with Gram-positive bacteremia and endocarditis, follow-up blood cultures in patients with Gram-negative bacteremia seldom provide useful information.
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Spinal Epidural Abscess
Non-operative management of spinal epidural abscess is safe and effective in selected patients.
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Self-administered Weekly Therapy for Latent Tuberculosis Is Non-inferior to Directly Observed Therapy in the United States
A randomized clinical trial conducted in the United States and three other countries compared self-administered isoniazid and rifapentine with and without weekly reminders to directly observed therapy (DOT). Self-administered therapy without reminders was non-inferior to DOT in the United States; no other comparisons met non-inferiority criteria.
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Physician Burnout: A Multi-specialty Perspective
Although different specialties address the problem of physician burnout, studies suggest the most effect is gained from organizational interventions.
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Deflating Recruitment Maneuvers
Compared to the ARDSNet lower positive end-expiratory pressure (PEEP)/low tidal volume strategy, use of an “open lung ventilation” strategy consisting of aggressive alveolar recruitment maneuvers and higher PEEP is associated with higher mortality in patients with moderate to severe acute respiratory distress syndrome.
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ORBITA: Learning the Right Lessons From a Sham-controlled Trial of Angioplasty
In this sham-controlled trial of 200 patients with single-vessel coronary artery disease and stable angina, percutaneous coronary intervention did not increase exercise time significantly compared to a placebo procedure.
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Risk of Major Bleeding With Concurrent Medications in Atrial Fibrillation Patients Taking New Oral Anticoagulants
A large nationwide comprehensive clinical database showed that concomitant use of the new oral anticoagulants with amiodarone, fluconazole, rifampin, and phenytoin increases the risk of major bleeding.
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Urine Output: The New Vital Sign?
An analysis of a large ICU database showed that hourly monitoring of urine output was associated with improved detection of acute kidney injury (AKI) and lower 30-day mortality in patients with AKI.