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California's proposed aerosol transmissible diseases standard covers a range of issues, including the minimum air exchanges per hour in negative pressure rooms (12, although they can be six if HEPA filtration is used), vaccination, and fit-testing. The standard would require employers to do the following:
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When it comes to occupational health salaries, "there is certainly not exponential growth, but it is not static, either," says Robert R. Orford, MD, CM, MS, MPH, president of the American College of Occupational and Environmental Medicine.
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A prospective study comparing angiographic clot burden score and ECG score in 105 patients with PE found no correlation between the two, and neither predictor correlated with 12-month mortality. In a second retrospective study of 33 consecutive patients with massive PE by conventional clinical criteria, there was also no correlation between findings on CT angiography and mortality.
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Valproic acid and phenytoin were equally effective in the treatment of acute repetitive seizures and status epilepticus.
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Forty-four acute care hospitals participated in a prospective study over four years to determine the effect of quality improvement (QI) interventions on appropriate prescribing of surgical antimicrobial prophylaxis. Hospitals were randomly assigned to either feedback on the results of the ongoing audit vs feedback plus an intensive collaborative intervention group. Both groups showed improvement in most quality indicators, but there appeared to be no benefit of the intensive QI collaborative intervention over performance feedback.
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Unfractionated heparin (UFH) is the standard bridging therapy for patients with mechanical heart valves who need to temporarily stop oral anticoagulants. Small case series have suggested that low molecular weight heparin (LMWH) may be useful for this purpose.
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Terminally ill cancer patients who had end-of-life discussions with their physician had better quality of life during their last week, and their caregivers had an easier bereavement.
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News: A mother went to two area emergency departments on three consecutive days, complaining of nausea, vomiting, headaches, and numbness in her extremities. Each time, she was prescribed medication to treat the nausea, diagnosed with a possible gastrointestinal infection, and sent home. Just days after her third ED visit, the woman passed out and fell down a stairway. She was taken to a third hospital, where a CT scan showed a brain tumor, and physicians determined that the woman had suffered a brain infarction.
