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In this issue: Drug combinations for hypertension; tenecteplase for
out-of-hospital cardiac arrest; CAM most commonly used for back, neck, and
arthritis pain; FDA Actions.
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Since 1993, clinical isolates of s. pneumoniae from normally sterile sites, including middle ear cultures, have been prospectively obtained from the Texas Children's Hospital clinical microbiology laboratory, and stored frozen.
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Accurate microbiologic diagnosis of prosthetic joint infection (PJI) is problematic. Infecting organisms reside in a biofilm, and standard culture techniques appear to have sub-optimal sensitivity.
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In a study designed to evaluate potential methods for improving survival by prevention of infection in ICU patients, de Smet et al used cluster randomization involving 13 centers in the Netherlands, with assignment to one of three treatment arms: selective decontamination of the gastrointestinal tract (SDD), selective oropharyngeal decontamination (SOD), or standard of care (SOC).
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Concerns have been raised that immigrants, especially those who are undocumented, afraid of deportation or who have limited financial resources, may be reluctant to present for care, thus compounding the risk for contagious diseases.
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Telemedicine has long been recognized for improving access to care as well as access to specialist expertise, particularly in rural facilities. Now, in an unpublished study just completed in Rochester, NY, the lead author says it also can offer a possible solution to overcrowding when it comes to pediatric ED patients, many of whom, he asserts, easily could be treated by a primary care physician.
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An emergency physician is managing an acute myocardial infarction, arranging for a patient transfer, sewing up a laceration, and putting in a chest tube, with 20 people still waiting to be seen in the waiting room.
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National economic paranoia seems to have taken over, and although ED volumes continue to climb, joblessness combined with the economic downturn promise to make it a rocky 2009 for many. There is a lot of emphasis on patient satisfaction, safety, and security these days, and each requires resources to manage. To sustain our objectives, it will be necessary to ensure the revenue streams to support them.
