Primary Care/Hospitalist
RSSArticles
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ID Ground Rounds — Stanford University: Male, 46, HIV Patient with Fever and Dyspnea
A 46-year-old man was admitted to our hospital due to progressive dyspnea, non-productive cough and fever. Two months prior to admission, he started to develop sustained weight loss and dyspnea associated with exertion. Ten-days prior to his presentation, dyspnea progressed to minimal exertion significantly limiting his functional status. -
Statins May Preserve Renal Function in Patients Receiving HAART
147 patients on stable antiretroviral therapy (ART) were randomized to receiving rosuvustatin 10 mg daily or placebo. After 24 weeks rosovustatin both reduced cystatin C and slowed kidney function decline as assessed by a serum creatinine-based equation. -
Infectious Disease (ALERT) Updates
Asymptomatic carriage of C. difficile in adult hospitalized patients varies regionally, but estimates suggest that 4% to 23% of patients being admitted to hospital in the U.S. may be colonized with toxogenic strains of C. difficile (TCD). -
Subglottic Secretion Suctioning Reduces Vent-Associated Pneumonia, Antibiotic Use
Ventilator-associated pneumonia (VAP) is a serious complication for intubated patients. It causes significant morbidity and mortality, increases healthcare costs and is the main reason for antibiotic use in the intensive care unit (ICU). -
Peri-procedural Management of New Oral Anticoagulants
Due to the short half-life and rapid onset of action of the new oral anticoagulants (NOACs), peri-procedural anticoagulant free time intervals should be shorter than with warfarin. Thus, there is uncertainty about the use of heparin bridging. These investigators from Germany analyzed the Dresden NOAC registry data to assess peri-procedural NOAC management and safety until 30 days post-procedure. -
Health Care Utilization in the Aftermath of Severe Sepsis
SYNOPSIS: This observational cohort study of survivors of severe sepsis found that the post-discharge needs of this population are substantial. Severe sepsis survivors spent more days admitted to facilities after their acute hospitalization than prior and had greater mortality, a steeper decline in days at home, and a greater increase in proportion of days alive in a facility compared to survivors of non-sepsis hospitalizations.
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Can We Reduce Unnecessary Head CT Scans in Patients with Delirium?
This study was a retrospective review of medical records of hospitalized general medicine patients with head CT imaging performed for the evaluation of delirium. -
Nasal High-Flow Oxygen Lowers Reintubation Rate
SYNOPSIS: Use of nasal high-flow oxygen was associated with better comfort, fewer desaturations and interface displacements, and a lower reintubation rate.
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The New Guidelines Put C. difficile on the Run
SYNOPSIS: Patients have decreased disease recurrence and mortality when physicians follow the IDSA/Society for Healthcare Epidemiology of America guidelines for the treatment of C difficile infection.
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Internal Medicine Alert - Full October 29, 2014 Issue in PDF