Hospital Medicine Alert – November 1, 2012
November 1, 2012
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Is Doxycycline Protective Against the Development of C. difficile infection?
A historical cohort study from San Francisco General Hospital evaluated patients ≥18 years old that were hospitalized and received at least one dose of ceftriaxone. In a multivariable analysis, for every day a patient also received doxycycline the rate of Clostridium difficile infection was 27% lower than for those who did not receive doxycycline (hazard ratio, 0.73%; 95% confidence interval, 0.56-0.96). -
New phlebovirus associated with severe febrile illness in Missouri
Two men presented to a hospital in northwestern Missouri in June 2009 with fever, fatigue, diarrhea, thrombocytopenia and leukopenia. Both had a history of frequent recent tick bites. A novel phlebovirus was isolated in cell culture from patient blood. Electron microscopy revealed virus particles consistent with Bunyaviridae. Sequencing identified the viruses as novel members of the phlebovirus genus. -
In Patients with Lacunar Strokes, Addition of Clopidogrel to Aspirin Does Not Reduce Risk of Recurrent Stroke
Small subcortical brain infarcts, known as lacunar strokes, account for about 25% of all ischemic strokes. -
IABP for MI with Cardiogenic Shock?
Patients who present with acute myocardial infarction (MI) complicated by cardiogenic shock represent a group at high risk for early mortality. Current guidelines recommend the use of intra-aortic balloon pump (IABP) for these patients, but there are few randomized, controlled trial data to support this. -
Stroke Risk with Warfarin Interruption
The risk of interrupting prophylactic warfarin for stroke prevention in atrial fibrillation (AF) patients is unclear. Thus, these investigators from Denmark evaluated their national health registry and found 102,591 patients > age 30 with a first-time hospitalization for AF between 1997 and 2008. -
Tele-ICU: Is It Worth It?
Based on their review of prior published studies of telemedicine ICUs and the initiation of a telemedicine ICU in a Veterans Health Administration hospital system, the authors find that costs of implementation are substantial and the sum impact on hospital expenses and profits remains unclear. -
Clinical Briefs in Primary Care Supplement