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Institution of a daily pharmacist-enforced intervention designed to improve adherence to sedation guidelines decreased the duration of mechanical ventilation and ICU stay.
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Elevated troponin i is a nonspecific finding, but suggests a poor prognosis regardless of its cause.
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Ceftobiprole, a novel broad-spectrum cephalosporin with activity against MRSA, was non-inferior to vancomycin plus ceftazidime in a study of complicated skin and skin-structure infections. This is the first β-lactam with reliable activity against methicillin resistant Staphylococcus aureus (MRSA) to be evaluated in advanced-stage clinical trials.
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Randomized studies of neuroprotective agents for ischemic stroke have resulted in a series of failures, as multiple agents, promising in animal models, have failed when applied to human subjects. By contrast, intracerebral hemorrhage (ICH) has been somewhat a "neglected stepsister" when compared to ischemic stroke; it has been studied minimally, despite its high morbidity and mortality.
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Three recent reports yield different conclusions on the effectiveness of MRSA surveillance on the incidence of healthcare associated MRSA infection.
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In this examination of blood C-reactive protein levels and clinical data in 570 patients hospitalized with community-acquired pneumonia, initial CRP levels < 100 mg/L were associated with fewer complications, less use of mechanical ventilation and/or inotropes, and lower 30-day mortality. Whether these findings provide useful information beyond what is apparent on routine clinical assessment remains to be seen.
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Epidural blood patch is an effective treatment for post dural puncture headache.
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Guillain-Barré syndrome remains a common and serious cause of acute neuropathy in the elderly.
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It has long been taught that lipid levels measured during hospitalization for an acute illness will be artificially low because of an acute-phase metabolic reaction. Consequently, many physicians wait weeks after hospitalization to measure lipids when they have returned to baseline levels and then start appropriate lipid lowering therapy. On the other hand, acute coronary syndrome (ACS) studies have suggested that the early administration of statins may improve outcomes in ACS.
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This study of a very large prospective series of cardiac arrests in over 500 US hospitals found that survival rates were lower during nights and weekends, differences that persisted despite adjustments for patient, resuscitation event, and hospital characteristics.
