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Hospital Medicine Alert – May 1, 2010

May 1, 2010

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  • Can We Accurately Predict Fluid Responsiveness?

    This non-randomized, prospective trial demonstrated that passive leg raising can be used to predict fluid responsiveness in non-intubated, spontaneously breathing patients with severe sepsis or acute pancreatitis.
  • NT-pro BNP

    Natriuretic peptide levels (BNP, NT-proBNP) are of prognostic value in general populations, but whether they add information to other known risk factors for cardiovascular outcomes is less clear.
  • Fusobacterium and Tonsillar Infections

    In this study, 847 patients with peritonsillar abscess (PTA) admitted to Aarhus University hospitals from 2001-2006 were included in this retrospective study.
  • Colistin and Acute Respiratory Failure

    Colistin, a 50-year-old polymyxin antibiotic that recently has been reintroduced to treat multidrug-resistant hospital-acquired Acinetobacter or Pseudomonas pneumonia, can cause acute neuromuscular weakness and precipitate acute hypercapnic respiratory failure, as illustrated by this case report.
  • STEMI Patients with Multi-vessel Disease — Culprit- vessel PCI vs. Multi-vessel PCI

    Patients presenting with ST-segment elevation myocardial infarction (STEMI) often have co-existing lesions in the non-infarct arteries (i.e., they have multi-vessel disease). These patients present a management dilemma.
  • Infection in HIV Patients

    In a prospective surveillance study, 50 HIV-positive patients who presented with febrile respiratory symptoms were evaluated for the presence of respiratory viruses by multiplex RT-PCR and a microarray assay and for atypical bacterial pathogens by PCR, in addition to sputum cultures and serologic testing. Viruses accounted for 64% of the infections. Influenza virus was identified in 22 cases, and human metapneumovirus (hMPV) was next most common, with six cases.
  • Supplement: Health Care Reform Update

    Health care clinicians and organizations likely will find that the new health care reform bill's positive features outweigh its drawbacks, experts say.