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Physicians at the University of California-San Diego (UCSD) report a cluster of 5 cases of cutaneous Leishmaniasis in illegal immigrants from East Africa, which surprisingly turned out to be consistent with New World Leishmaniasis, although all 5 had come from an area endemic for Old World Leishmaniasis. How did this occur?
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Add Tdap to the growing list of recommended (and often required) vaccinations for health care workers (HCWs) in hospital, including MMR, hepatitis B, influenza, and possibly varicella. In April, the American College of Immunization Practices (ACIP) issued provisional recommendations for pertussis vaccination (Tdap) of all hospital HCWs, regardless of age and prior vaccine history (i.e., regardless of the time since last Td dose).
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In the ICUs of a well-staffed academic medical center committed to quality improvement, in which closed staffing, multidisciplinary rounds, and the daily use of checklists were already in place, implementation of a 24-hour ICU telemedicine system that was well accepted by the medical staff was associated with impressive improvements in adherence to best practice standards as well as with reductions in hospital mortality and lengths of stay.
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The authors advocate that cardiovascular magnetic resonance imaging using specific criteria may be useful as a diagnostic tool for patients with stress cardiomyopathy at the time of acute clinical presentation.
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In this study, the authors attempt to develop a risk stratification score to predict bleeding in patients treated with warfarin oral anticoagulation.
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Intensivists experienced significantly less burnout, work-home life imbalance, and job distress under an interrupted schedule vs a continuous (half-month) schedule. ICU length of stay and mortality were non-significantly higher under continuous scheduling.
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My hospital has a contract to provide medical care to the county jail. At any one time, there are more than 10,000 inmates in the county jail facilities supervised by the sheriff's office. We often see patients who are in custody and have sustained trauma, sometimes from less than lethal weapons. In my humble opinion, these devices reduce the risk of injury to the law enforcement officer when attempting to arrest or control a violent individual, and they greatly reduce the risk of serious injury or even death to the violent individuals themselves. However, even these less than lethal force weapons can cause significant damage when used at close range or on individuals with underlying medical conditions that render them vulnerable to the effects of these weapons.
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