Hospital Medicine Alert – September 1, 2010
September 1, 2010
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Medical Emergency Teams: Does Rapid Response Make a Difference?
In this before-and-after study of more than 275,000 patients admitted to a Swedish hospital before-and-after implementation of a medical emergency team, in-hospital cardiac arrests decreased and overall in-hospital mortality fell by 10% in the two years following the team's implementation. -
PO Is OK for COPD — Follow the Guidelines!
There is no difference in rates of treatment failure, death, or readmission for COPD between patients treated with oral or intravenous steroids for exacerbation of COPD, but the IV route may be associated with increased cost and length of stay. -
Blood Culture-negative Endocarditis: What Can the Laboratory Bring to the Table?
The etiology of blood culture-negative endocarditis was identified in 62.7% of 759 patients using combinations of serological, molecular, and histopathological assays. The majority of the agents not detected by conventional cultures were Coxiella burnetii (30%) and Bartonella spp. (11%), both diagnosed using serological tests, and Trophyrema whipplei, other unusual bacteria, and fungi making up the remainder. For 14% of patients, diagnosis required PCR testing on valve tissue removed during surgery (not in paraffin). The cause of disease could not be determined for 264 patients; 2% of patients had non-infectious endocarditis. -
Do Rapid Response Teams Reduce Hospital Mortality or Simply Increase Costs?
This meta-analysis casts serious doubt on the ability of rapid response teams to significantly reduce hospital mortality. -
Catching Dengue in Florida
Autochthonous transmission of dengue virus infection has been detected in Florida.