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Gastrointestinal (GI) bleeding is a major complication of dual anti-platelet therapy (DAPT) with aspirin and clopidogrel.
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The relationship between blood pressure and cardiovascular events remains controversial, especially in patients with coronary artery disease who may need increased pressures to have adequate myocardial perfusion.
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In a multicenter study, critically ill patients with initial hyperlactatemia had improved outcomes (including shorter ICU stays and lower adjusted mortality) compared to control patients when they were managed for the first 8 hours with a resuscitation protocol targeted at reducing the lactate level by at least 20% every 2 hours.
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A 74-year retired veterinarian presents to the emergency department (ED) with shortness of breath. He was recently diagnosed with diffuse large-cell lymphoma with prominent abdominal lymphadenopathy and positive bone marrow and has been treated with two cycles of R-CHOP.
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Episodes of severe sepsis in older adults is associated with worsening cognition and functional status.Source: Iwashyna TJ, et al. Long-term cognitive impairment and functional disability among survivors of severe sepsis. JAMA 2010;304:1787-94.
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The federal government has made clear many times in the past that if an industry can't clean up its own house, the feds will come in and do it for them in a way far more onerous than anything the industry might have done on its own. That's what is about to happen with discharge planning, say some industry insiders.
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Telephone intervention can improve discharge planning when it is done in the right way, by the right people, according to the results of a program at Rush University Medical Center in Chicago.
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A "high risk for readmission action team" (HRRAT) could be the way to address one of the weakest points in the discharge process, the day or two immediately after the patient goes home, says one doctor in Texas.
