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Hospital Medicine Alert – June 1, 2008

June 1, 2008

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  • Survival from In-Hospital Cardiac Arrest is Worse at Night/Weekends

    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.
  • Can We Improve Our Vasopressor Management in Patients with Septic Shock?

    This multi-center, randomized, double-blind clinical trial demonstrated that the addition of vasopressin to patients receiving norepinephrine for management of septic shock had no effect on mortality when compared to increasing the norepinephrine dose.
  • Blood Clots and "The Patch"

    The risk of venous thromboembolism was double in users of a transdermal contraceptive as compared to users of an oral contraceptive with a 35 mcg ethinyl estradiol component. Warning: no abstract skimming — it's worth your while to keep reading!
  • Value of Volume Expansion in Cardiac Tamponade

    Intravascular volume expansion has long been advised as an effective temporizing technique for patients with cardiac tamponade prior to drainage of the fluid, but there is little data supporting this practice.
  • A New Drug for Rapid Conversion of AF

    Vernakalant is a new investigational anti-arrhythmic drug. The compound is relatively selective, blocking the early-activating potassium channel and the frequency-dependent sodium channel; it has a half-life of two to three hours.
  • Pharmacology Watch

    Pioglitazone and heart disease; ARBs manufacturers spend millions to show the non-inferiority of their products compared to less expensive, generic ACE inhibitors; some athletes turn to growth hormone because it is difficult to detect; FDA Actions