Hospital Medicine Alert – December 1, 2006
December 1, 2006
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Antiretrovirals for Acute HIV Infection — Not Ready for Prime Time
A multicenter, observational study retrospectively compared 59 individuals with acute or early HIV infection who elected to receive antiretroviral (ARV) therapy for 12 weeks to 337 patients who declined treatment. -
Volume May (Or May Not) Impact Mortality in ICU Patients
In 2 studies, mechanical ventilation in a hospital with a high case volume was associated with reduced mortality for nonsurgical patients, either regardless of severity of illness (Kahn et al) or only in high-risk patients (Glance et al). -
Clinician Estimates of Ideal Body Weight Are Inaccurate
When ICU clinicians estimated rather than calculated ideal body weight in mechanically ventilated patients in order to set tidal volume, the majority of such estimations were sufficiently inaccurate that the resulting tidal volume was outside the unit's target range. -
Risk Stratification in Acute Coronary Syndromes
ECG ST depression was strikingly predictive of outcomes in ACS patients, compared to new biomarkers. -
The Effect of Maternal Oxygen Administration on Fetal Pulse Oximetry During Labor in Fetuses with Nonreassuring Fetal Heart Rate Patterns
The administration of supplemental oxygen to laboring patients with nonreassuring fetal heart rate patterns increases fetal oxygen saturation substantially and significantly. Fetuses with the lowest initial oxygen saturations appear to increase the most. -
Fatal Plague in the US
Each year in the United States, a few isolated cases of plague are reported. This year, possibly because of increased spring rains leading to an increase in the rodent population, an unprecedented 13 cases of plagues have occurred in 4 states already.