Browse Clinical Articles by Topic

A Guide to When and How to Stop CPR

Although health care providers undergo hours of training and re-certification to provide resuscitative efforts for patients in cardiopulmonary arrest, few are given guidance in terms of when and how to stop it.

Post-ICU Stress Symptoms Associated with Increased Acute Care Service Utilization

Over the past two decades, advances in critical care have resulted in more patients surviving to hospital discharge, but these successes are attenuated by several sequelae of critical illness, including depression and post-traumatic stress disorder (PTSD).¹ Risk factors for and the health care ramifications of these disorders are poorly understood. Given this, Davydow and colleagues aimed to investigate whether PTSD symptoms in the acute (< 1 month) ICU hospitalization period and PTSD and depressive symptoms at 3 months post-ICU were risk factors for future hospitalizations and emergency department (ED) visits.

Nasal Screening for MRSA: The New Basis for De-escalation of Empiric Antibiotics?

Although nasal screening for methicillin-resistant Staphylococcus aureus (MRSA) is a widely accepted method for infection control, the relationship between nasal carriage and development of MRSA lower respiratory tract infection (LRTI) is not well studied. Tilahun and colleagues sought to determine the association between MRSA nasal swab results and MRSA LRTI in a medical ICU. In this single-site, retrospective cohort study, 165 patients were diagnosed with pneumonia and had both nasal swabbing and culturing of respiratory specimens within 24 hours of admission.

Inpatient and Outpatient Care Providers: Why Can’t We Just Work Together?

Many problems occur after a patient is discharged that are a direct result of poor coordination of care between hospitalists and primary care providers (PCPs). These issues include, but are not limited to, missed test results, medication errors, inadequate follow up, and harm to the patient. PCPs are frequently unaware that their patient was hospitalized and they often do not receive a copy of the discharge summary. The authors of this paper did a qualitative study to analyze the barriers and solutions to care coordination between hospitalists and PCPs in North Carolina.

Low-lying Intrauterine Devices: To Remove or Not to Remove?

It is not uncommon that we receive reports from radiology regarding the location of an intrauterine device (IUD) in a patient that we have sent for a pelvic ultrasound examination for an entirely different reason (e.g., an adnexal mass). These incidental findings of low-lying or malpositioned IUDs are a conundrum for the practitioner.

Diagnostic Concordance in Breast Biopsies

A comparison of breast biopsy diagnosis by clinical pathologists found a 75% concordance with a consensus-derived expert diagnostic interpretation. Concordance was lowest with the diagnosis of atypical, with under-diagnosis noted in 35% of cases.

Intrauterine Insemination Outcomes Are Not Affected by Sperm Morphology Parameters

Pregnancy rates following intrauterine insemination are not affected by abnormalities of sperm morphology.

Using Etonogestrel Implants and LNG-IUDs Past FDA-approved Duration

In this small prospective cohort study, use of the etonogestrel implant and the levonorgestrel intrauterine device for an additional year past their FDA-approved duration was associated with an acceptably low failure rate.

OnabotulinumtoxinA and the Bladder

ABSTRACT & COMMENTARY: Healthcare providers should thoroughly counsel patients on the risks associated with onabotulinumtoxinA toxin injections.

Nurses text, send images from the OR with new app

Arnold Palmer Hospital for Children in Orlando, FL, uses a new app that feeds information from the operating room directly to the smartphones of a patient’s family and loved ones. It’s called EASE, which stands for Electronic Access to Surgical Events.