Hospital Medicine Alert – December 1, 2011
December 1, 2011
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Incidence of Constrictive Pericarditis
Since there is a lack of prospective data on the frequency of which constrictive pericarditis (CP) develops after acute pericarditis (AP), this group of investigators from Torino, Italy, conducted such a study. -
Risk of Perioperative MI in Patients with Stents Undergoing Surgery
Patients who have had percutaneous coronary intervention (PCI) with either bare metal stents (BMS) or drug-eluting stents (DES) require dual antiplatelet therapy until the stent struts are endothelialized. However, patients who have had prior PCI often need to undergo surgery. -
Saddle Pulmonary Embolism: Is It the Same as 'Massive' PE?
Saddle pulmonary embolism was found in 37 of 680 patients with documented pulmonary embolism (PE) in this community hospital study. The great majority of these patients did well on standard therapy without thrombolytics, emphasizing that the radiographic finding of saddle PE should not by itself be equated with the much more serious clinical entity of massive PE. -
Risks of ICU Admission Include Unintentional Discontinuation of Medications
Admission to an ICU increased risk for unintentional medication discontinuation in four of five medication groups commonly used to manage a chronic illness. -
Daily Prompting on ICU Checklist Use Improves Patient Outcomes as Well as Processes of Care
In this study from a single medical ICU, prompting physicians to discuss all six items on a daily rounding checklist, as compared with the use of the same checklist without prompting, significantly improved several processes of care and appeared to decrease length of stay and mortality as well. -
ACE Inhibitors/ARBs for Aortic Stenosis?
In severe symptomatic aortic stenosis (AS), surgical AVR improves mortality, but there is no medical therapy proven to slow progression of the valvular stenosis. Because AS is accompanied by left ventricular (LV) hypertrophy and fibrosis, and because the risk factors for AS are similar to those for coronary artery disease (CAD), it makes sense that blockade of the renin-angiotensin system may benefit patients with AS.