Hospital Medicine Alert
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NOTICE: February 2018 was the final issue of this publication.
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Rehabilitation From Neurological Insults: The Role of Music-based Interventions
This large-scale review study brings promising direction to the field; understanding the effect of specific musical interventions on specified outcomes could and should lead to a more targeted and efficacious approach. -
Thrombectomy Is Effective Up to 24 Hours After Stroke – the DAWN Trial
Among a group of ischemic stroke patients last known to be well six to 24 hours earlier and who had a mismatch between clinical deficit and infarct size, outcomes regarding disability and functional independence were better if treated with mechanical thrombectomy, rather than standard care alone.
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Implementing Noninvasive Ventilation: If You Build It, They Will Come
This study affirmed that giving allied health professions autonomy to execute care within well-structured, supervised protocols/guidelines is an efficient solution to many of the current obstacles in providing patient care in an increasingly fractured environment. -
More ICU Care Does Not Equal Better Survival for Elderly Patients
With an aging population and growing numbers of ICU beds, the question arises as to whether the ICU truly is beneficial for this vulnerable population. To explore this question, a cluster-randomized, clinical trial was designed to determine whether a method of systematic ICU admission in critically ill elderly patients reduced six-month mortality.
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Follow-up Blood Cultures in Gram-negative Bacteremia — Don’t Order Them
Not only does ordering routine follow-up blood cultures in patients with GNR bacteremia seldom produce helpful information, but common false-positive results can lead to longer length of stay, additional inappropriate antibiotic therapy, and increased healthcare costs.
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Physician Burnout: A Multi-specialty Perspective
Although different specialties address the problem of physician burnout, studies suggest the most effect is gained from organizational interventions.
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Deflating Recruitment Maneuvers
Compared to the ARDSNet lower positive end-expiratory pressure (PEEP)/low tidal volume strategy, use of an “open lung ventilation” strategy consisting of aggressive alveolar recruitment maneuvers and higher PEEP is associated with higher mortality in patients with moderate to severe acute respiratory distress syndrome.
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ORBITA: Learning the Right Lessons From a Sham-controlled Trial of Angioplasty
In this sham-controlled trial of 200 patients with single-vessel coronary artery disease and stable angina, percutaneous coronary intervention did not increase exercise time significantly compared to a placebo procedure.
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Risk of Major Bleeding With Concurrent Medications in Atrial Fibrillation Patients Taking New Oral Anticoagulants
A large nationwide comprehensive clinical database showed that concomitant use of the new oral anticoagulants with amiodarone, fluconazole, rifampin, and phenytoin increases the risk of major bleeding.