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Hospital Medicine Alert – August 1, 2010

August 1, 2010

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  • Does "Auto-anticoagulation" Protect Against VTE in Patients with Liver Disease?

    In this retrospective study of patients hospitalized because of severe chronic liver disease, venous thromboembolism was relatively common and "auto-anticoagulation" in the form of an elevated INR had no apparent protective effect.
  • Myocardial Infarction

    The use of angiotensin converting enzyme (ACE) inhibitors in all acute myocardial infarction (MI) patients is controversial. Thus, these investigators from the Register of Information and Knowledge about Swedish Heart Intensive Care Admissions (RIKS-HIA) examined the association between ACE inhibitor therapy and mortality in unselected patients with acute MI.
  • Acinetobacter Spreads its Wings

    Serious infections caused by Acinetobacter baumannii are appearing in the community, spread by patients who acquired the organism in the hospital setting, and conversely, the organism is being introduced into the hospital from long-term nursing care patient settings. Resistance to antimicrobial agents has increased over the six-year study period, along with the severity of disease.
  • Diarrhea vs. Death: You Decide

    Early antibiotic administration was associated with reduced likelihood of death, mechanical ventilation, and readmission (but increased risk of Clostridium difficile infection) among patients hospitalized for acute exacerbations of COPD.
  • Oral Nutritional Intake among Critically Ill Patients Is Grossly Deficient in the Week Following Extubation

    In a prospective study of the actual oral nutritional intake of patients with respiratory failure in the first week following extubation, average intake failed to exceed 50% of daily requirements on all seven days.