Hospital Medicine Alert – April 1, 2009
April 1, 2009
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Rapid Diagnosis of Pulmonary Tuberculosis
Nucleic acid amplification (NAA) testing should be performed on at least one respiratory specimen from each patient with signs and symptoms of pulmonary TB for whom a diagnosis of TB is being considered but has not yet been established, and for whom the test result would alter case management or TB control activities. -
Oseltamivir (Tamiflu) Resistance in Seasonal Influenza A (H1N1) Viruses
Preliminary data indicate that the prevalence of influenza A (H1N1) virus strains resistant to the antiviral medication oseltamivir is high. Therefore, interim guidelines issued by the CDC are to use zanamivir or a combination of oseltamivir and rimantidine if influenza A (H1N1) infection is suspected. -
Stroke is Associated with Central Periodic (Cheyne-Stokes) Breathing
Sleep disordered breathing occurs in most acute stroke patients and may contribute to morbidity -
Steroids to Prevent Extubation Failure?
This meta-analysis of studies examining the efficacy of systemic corticosteroids for preventing laryngeal edema following extubation concludes that this treatment is effective. This result differs from those of several previous meta-analyses, and raises practical issues such as whether extubation should be delayed for at least 12 hours after a patient passes a spontaneous breathing trial and qualifies for extubation so that a course of steroids can be given. -
Newer Antipsychotic Drugs and Sudden Death
Ray et al examined the computerized files of Tennessee Medicaid recipients to estimate the effects of atypical antipsychotic drugs on the risk of sudden cardiac death.