Primary Care/Hospitalist
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Emergency Medicine Reports - Full November 30, 2014 Issue in PDF
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The Photosensitive Patient
A 65-year-old female presents to the emergency department with a chief complaint of a severe rash. The rash has been present for two weeks on her arms, neck, and scalp. It began while she was sitting on her porch one afternoon. She denies any associated fevers, chills, headache, or muscle ache. She denies any exposure to pets, new soaps, detergents, or lotions, and she denies recent travel.
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Pediatric Myocarditis
Myocarditis can at times be asymptomatic and has a varied presentation; consequentially, it often goes undiagnosed and its true incidence is unknown -
Internal Medicine Alert - Full October 29, 2014 Issue in PDF
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The New Guidelines Put C. difficile on the Run
SYNOPSIS: Patients have decreased disease recurrence and mortality when physicians follow the IDSA/Society for Healthcare Epidemiology of America guidelines for the treatment of C difficile infection.
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Nasal High-Flow Oxygen Lowers Reintubation Rate
SYNOPSIS: Use of nasal high-flow oxygen was associated with better comfort, fewer desaturations and interface displacements, and a lower reintubation rate.
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Can We Reduce Unnecessary Head CT Scans in Patients with Delirium?
This study was a retrospective review of medical records of hospitalized general medicine patients with head CT imaging performed for the evaluation of delirium. -
Health Care Utilization in the Aftermath of Severe Sepsis
SYNOPSIS: This observational cohort study of survivors of severe sepsis found that the post-discharge needs of this population are substantial. Severe sepsis survivors spent more days admitted to facilities after their acute hospitalization than prior and had greater mortality, a steeper decline in days at home, and a greater increase in proportion of days alive in a facility compared to survivors of non-sepsis hospitalizations.
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Peri-procedural Management of New Oral Anticoagulants
Due to the short half-life and rapid onset of action of the new oral anticoagulants (NOACs), peri-procedural anticoagulant free time intervals should be shorter than with warfarin. Thus, there is uncertainty about the use of heparin bridging. These investigators from Germany analyzed the Dresden NOAC registry data to assess peri-procedural NOAC management and safety until 30 days post-procedure. -
End-of-Life and Futile Medical Care in the Emergency Department
The purpose of this article is to review the complicated issues of end-of-life and futile medical care as applicable to the emergency department (ED). It will address sources of conflict and confusion, and will conclude with a practical discussion of how emergency physicians can best navigate these complex waters by practical case review.