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Urinary Tract Infection

MONOGRAPH: More than 8 million medical visits per year are for the chief complaint of UTI and the diagnosis accounts for 100,000 admissions annually.

Complications post-thyroid surgery lead to patient death, $1.3 million verdict

News: A patient undergoing thyroid surgery was accompanied to the hospital by her sister and daughter. After surgery, the patient began to struggle with her breathing. The patient’s sister and daughter observed the surgeon and nurses work on the patient for more than 30 minutes, during which time the patient’s condition deteriorated until the patient stopped breathing and lost her pulse, which led to permanent brain injury. The patient died 10 days later.

Failure to diagnose cauda equina syndrome results in $2.5 million verdict from jury

News: A 19-year-old woman sought treatment at a local hospital ED for severe lower back pain and pelvic numbness. A nurse practitioner quickly discharged her and attributed the symptoms to common back pain. The ED physician failed to consult with the patient, but subsequently approved the nurse’s actions. Two days later, the patient was diagnosed with cauda equine syndrome but had suffered serious and permanent injuries.

Clinical Briefs

Clinical Briefs on topics such as: Chronobiology and Insulin Glargine, Dual Add-on Therapy for Type 2 Diabetes When Metformin is Not Enough, and Might Long-term Dual Antiplatelet Therapy Be Better? Not

Are Atrial Premature Complexes Benign?

Atrial premature complexes (APCs) are commonly observed on routine ECGs and believed to be harbingers of atrial fibrillation, especially in patients with cardiovascular disease. However, little is known about the long-term prognosis of APCs in the general population. Thus, these investigators from Japan analyzed the database of a large community-based cohort from 1993 to 2008 to determine the risks of APCs seen on the subjects’ baseline ECGs.

Statins After an MI: Does it Happen?

Following a hospitalization for coronary heart disease (CHD) or acute coronary syndrome (ACS), randomized trials demonstrate that high-intensity atorvastatin is more effective than either placebo or low- to moderate-intensity therapy with either pravastatin or atorvastatin.^1-3 Based on this evidence, the American College of Cardiology and the American Heart Association guidelines recommend high-intensity therapy in cases of an acute cardiac event and that therapy be initiated before discharge.

Is it Worth it? Do “Healthy” Dietary Guidelines Lower the Risk of Heart Disease?

Recent controversy surrounds diet and its impact on cardiovascular disease (CVD). In this study, Reidlinger and her colleagues sought to assess diet by comparing the effects on vascular and lipid CVD risk factors of adhering to a diet consistent with United Kingdom (UK) dietary guidelines (DG group) to a traditional British diet (control group).

Another Reason to Recommend Smoking Cessation

Atrial fibrillation (AF) is the most common arrhythmia encountered in clinical practice, affecting an estimated 2.7 million individuals in the United States.¹ The proportion of strokes attributable to AF increases strikingly from 1.5% at 50-59 years of age to 23.5% at 80-89 years of age.² Approximately 15-20% of all strokes are due to AF. To predict the thromboembolic risk in the individual patient, risk models used most frequently are CHA2DS2-VASc and CHADS2 scores. The CHA2DS2-VASc score may be the better option since both the 2014 American Heart Association, American College of Cardiology, Heart Rhythm Society AF guidelines, and the 2012 European Society of Cardiology AF guidelines prefer it when evaluating the individual thromboembolic risk associated with AF and to determine the risk:benefit ratio of antithrombotic therapy.³

Impaired physicians have ethical obligation to self-report, experts say

Do physicians have diminished capacity as a result of substance abuse, burnout, behavioral or psychological issues, or physical illness? Regardless of the reason for impairment, physicians have an ethical obligation to protect their patients from harm.

Parents eager for newborn genomic testing; ethical questions currently unanswered

Parents have widespread interest in genome sequencing for newborns, regardless of their demographic background, according to a recent study led by researchers at Brigham and Women’s Hospital and Boston Children’s Hospital. Researchers queried 514 parents within 48 hours of a child’s birth.¹