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Hospital Medicine Alert – May 1, 2009

May 1, 2009

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  • Oral Vitamin K for Excessive Anticoagulation

    Whether oral vitamin K reduces the risk of bleeding related to excessive anticoagulation from warfarin remains unclear.
  • MRSA Central-Line Bacteremias Decline in U.S. ICUs

    Surveillance data from the CDC show that central-line associated bloodstream infections due to methicillin-resistant Staphylococcus aureus in U.S. intensive care units showed an overall decrease of 50% during 1997-2007.
  • Clopidogrel Plus Proton-Pump Inhibitors

    Since the risk of gastrointestinal bleeding is increased when clopidogrel is added to aspirin therapy in patients with acute coronary syndromes (ACS), many prescribe proton-pump inhibitors (PPIs) to reduce this risk. However, mechanistic studies suggest that PPIs may reduce the effectiveness of clopidogrel.
  • Dronedarone: New and Improved Amiodarone?

    Dronedarone is a new antiarrhythmic drug with structural similarities to amiodarone. During development of the molecule, the steps included removal of the iodine atoms and making the compound more lipophilic; the latter produces a shorter elimination half-life and reduced tissue accumulation.
  • Greater In-hospital Use of Clinical IT is Associated with Better Patient Outcomes

    In this study of physician use of clinical information technology in relation to 4 common diagnoses in 41 urban hospitals in Texas, inpatient outcomes were better the more extensive the use of computerized order entry, test results, physician charting, and decision support. Increased use of IT was also associated with significantly lower costs for all hospital admissions.