Hospital Medicine Alert – August 1, 2011
August 1, 2011
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Avoid NSAIDs After Myocardial Infarction
Current American College of Cardiology/ American Heart Association (ACC/AHA) Guidelines recommend withholding non-steroidal anti-inflammatory drugs (NSAIDs) from patients who have suffered a myocardial infarction (MI) and substitution of another analgesic such as acetaminophen. If NSAID therapy is unavoidable, the guidelines recommend the shortest duration possible. -
Supplemental Oxygen Administration in the Morbidly Obese: When Less Is Better
This single-center, double-blind, randomized, controlled crossover trial demonstrated that administration of 100% oxygen to stable patients with obesity hypoventilation syndrome leads to decreased minute ventilation, increasing dead-space to tidal volume ratio, and worsening hypercapnia. -
Sleep Apnea and Perioperative Complications After Noncardiac Surgery
In a population-based study using hospital discharge diagnosis codes, patients with sleep apnea who underwent knee arthroplasty or open abdominal procedures were more likely to require invasive mechanical ventilation and to be diagnosed with aspiration pneumonia or ARDS than were matched patients without sleep apnea. Knee-replacement patients, but not those undergoing laparotomy, also were more likely to be diagnosed with pulmonary embolism. -
Bacterial Meningitis: Rarer, in Older Patients, but Equally Deadly
With the advent of new vaccines, the incidence of bacterial meningitis has declined, particularly in children, but the mortality rate has remained the same. -
Proton Pump Inhibitors and Clopidogrel
Proton pump inhibitor use in clopidogrel-treated post-percutaneous coronary intervention patients was not associated with an increased risk of all-cause death, nonfatal myocardial infarction, repeat revascularization, or major adverse cardiovascular events.