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Hospital Medicine Alert – February 1, 2012

February 1, 2012

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  • B-lactam/B-lactamase Inhibitors for Treatment of Bacteremia due to ESBL-producing E.coli

    A post hoc analysis of patients with bacteremia due to ESBL-producing E.coli (ESBL-EC) from 6 published cohorts was performed. Treatment with B-lactam/B-lactamase inhibitors (BLBI) vs. carbapenems did not show any difference in mortality or length of hospital stay.
  • Fever in Travelers After Visiting Malaria-endemic Areas

    Common specific causes of fever in Finnish returned travelers were Campylobacter, malaria, bacteremia, HIV, and influenza; they included a significant proportion of potentially life-threatening infections, and more than one diagnosis. Evaluation of such fevers should be systematic and thorough.
  • Insurance Status and ICU Outcomes

    In this study of a statewide administrative database, among 138,720 adult patients admitted to an ICU, uninsured patients had a 25% higher likelihood of death within 30 days compared with privately insured patients, differences that persisted after multiple adjustments for demographics, severity of illness, and site of care. Uninsured patients received central venous catheterization, acute hemodialysis, and tracheostomy significantly less often than insured patients.
  • What is the Healthiest Systolic Blood Pressure Range for Patients After an Ischemic Stroke?

    A post-stroke analysis of more than 20,000 patients in 35 countries showed that the lowest risk systolic blood pressure (BP) range is 130-139 mmHg. There is a J-shaped curve of risk with an increase in recurrent stroke among patients with a systolic BP below 120 mmHg and above 140 mmHg.
  • Lyme Meningitis in Children with Aseptic Meningitis

    The prevalence of Lyme meningitis among children with nonspecific aseptic meningitis occurring from April through December in the years 2006 through 2009 in an endemic area for Lyme disease was 13.3% (95% confidence interval [CI], 6.3%-25.1%).