How Risk Factors for SIDS Have Changed Since the Back-to-Sleep Campaign
A higher percentage of cases are now associated with side sleep position and bed-sharing, and prone position still accounts for 30% of cases.
Clot Risk Remains High in Medical Patients After Discharge
Hospital Medicine Summary and Comment
A study of medically ill hospitalized patients revealed that more than half of venous thromboembolic events occurred after hospital discharge.
Low-Dose vs. Standard-Dose CT for Appendicitis
Emergency Medicine Summary and Comment
Free
Low-dose computed tomography was noninferior to standard-dose CT for evaluating suspected appendicitis in nonobese young adults.
The 23-mg Donepezil Dilemma
Neurology News in Context
Criticism of FDA approval of higher-dose donepezil escalates from consumer advocacy groups to health policy clinicians
Estrogen Therapy and Breast Cancer Risk: More from the Women's Health Initiative
Women's Health Summary and Comment
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Incidence of and mortality from breast cancer were clearly lower than in women who received placebo.
Long-Term Effects of Mild Traumatic Brain Injury Are Not So Mild
Children with mild TBI can experience physical and cognitive symptoms and impaired function for many months.
By Cornelius W. Van Niel, MD
March 21, 2012
Covering:
Yeates KO et al., Arch Pediatr Adolesc Med 2012 Mar 5
Rivara FP., Arch Pediatr Adolesc Med 2012 Mar 5
Represcribing High-Risk Drugs After Acute Upper Gastrointestinal Bleeding
Gastroenterology Summary and Comment
Within 1 year after a bleeding episode, many patients were again receiving the potentially causative drug — but often with a proton-pump inhibitor.
Prehospital Epinephrine for Cardiac Arrest Reduces Survival and Worsens Neurological Outcomes at 1 Month
Emergency Medicine Summary and Comment
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A large observational study places added scrutiny on the use of epinephrine for out-of-hospital cardiac arrest.
By John A. Marx, MD, FAAEM
March 23, 2012
Covering:
Hagihara A et al., JAMA 2012 Mar 21; 307:1161
Callaway CW., JAMA 2012 Mar 21; 307:1198
Job Satisfaction, Burnout, and Worklife Balance Among Hospitalists
Hospital Medicine Summary and Comment
A national survey indicates that job satisfaction is high, compensation schemes differ among practice models, and burnout is not uncommon.
By Grace C. Huang, MD
March 5, 2012
Covering:
Hinami K et al., J Hosp Med 2012 Jan 23
Hinami K et al., J Gen Intern Med 2012 Jan; 27:28
Reducing Nosocomial UTIs: War on Urinary Catheters in Michigan
Infectious Diseases Summary and Comment
A statewide quality-improvement effort dramatically reduced catheter use.
By Larry M. Baddour, MD
March 7, 2012
Covering:
Fakih MG et al., Arch Intern Med 2012 Feb 13; 172:255
Mourad M and Auerbach A., Arch Intern Med 2012 Feb 13; 172:260
Johansen KL., Arch Intern Med 2012 Feb 13; 172:262
Septic Shock? Reach for Norepinephrine After Fluid Resuscitation
Emergency Medicine Summary and Comment
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A meta-analysis shows that dopamine is associated with increased risk for death and arrhythmic events compared with norepinephrine.
By Kristi L. Koenig, MD, FACEP
March 2, 2012
Covering:
De Backer D et al., Crit Care Med 2012 Mar; 40:725
Annane D., Crit Care Med 2012 Mar; 40:981
Apixaban vs. Aspirin for Secondary Stroke Prevention in Atrial Fibrillation
Neurology Summary and Comment
This new oral anticoagulant drug significantly reduced the rate of thromboembolism without increasing the rate of intracranial hemorrhage.
By Hooman Kamel, MD
March 6, 2012
Covering:
Diener H-C et al., Lancet Neurol 2012 Mar; 11:225
More Evidence That ED Crowding Harms Patients
Emergency Medicine Summary and Comment
Free
Boarded patients experience medication delays, longer hospital stays, and higher mortality but are less likely than nonboarded patients to experience delays in some tests.
By Diane M. Birnbaumer, MD, FACEP
January 27, 2012
Covering:
Singer AJ et al., Acad Emerg Med 2011 Dec; 18:1324
Sills MR et al., Acad Emerg Med 2011 Dec; 18:1330
Liu SW et al., Acad Emerg Med 2011 Dec; 18:1339
Kennebeck SS et al., Acad Emerg Med 2011 Dec; 18:1380
Neurologists Sometimes Disagree with Emergency Physicians' Diagnoses of TIA
Emergency Medicine Summary and Comment
In a retrospective single-center study, features associated with discordant diagnoses were headache, involuntary movement, and dizziness.
Antipsychotics Vary in Mortality Risk in Dementia Patients
Psychiatry Summary and Comment
Haloperidol had the highest 6-month mortality rate; quetiapine, the lowest.
By Joel Yager, MD
February 6, 2012
Covering:
Kales HC et al., Am J Psychiatry 2012 Jan; 169:71
What Is IRIS Like in the U.S.?
Approximately 10% of patients responding to antiretroviral therapy developed immune reconstitution inflammatory syndrome, which was, in turn, associated with increased mortality risk.
By Paul E. Sax, MD
February 6, 2012
Covering:
Novak RM et al., AIDS 2012 Jan 10
Lifetime Cardiovascular Risk: The More Things Change . . .
Cardiology Summary and Comment
Risk factors are less prevalent than in the past, but they are just as predictive of outcome.
Preventing Readmissions: Should We Be Looking at the Hospital Exit or the Entrance?
Hospital Medicine Summary and Comment
Regional admission rates for congestive heart failure and pneumonia explain much of the variation in hospital readmission rates.
By Grace C. Huang, MD
January 23, 2012
Covering:
Epstein AM et al., N Engl J Med 2011 Dec 15; 365:2287
PPIs and CAP, Revisited
Infectious Diseases Summary and Comment
In a retrospective, nested case-control study, the risk for community-acquired pneumonia was 29% higher with current use of a proton-pump inhibitor than with past use.
By Neil M. Ampel, MD
January 18, 2012
Covering:
Hermos JA et al., Clin Infect Dis 2012 Jan 1; 54:33
Antidepressants and Fetal Risk: A New Look at SSRIs During Pregnancy
Women's Health Summary and Comment
Free
Maternal use of selective serotonin reuptake inhibitors during late pregnancy raised risk for neonatal pulmonary hypertension, but individual risk-benefit profiles should be evaluated.
By Allison Bryant, MD, MPH
January 19, 2012
Covering:
Kieler H et al., BMJ 2012 Jan 12; 344:d8012
Koren G and Nordeng H., BMJ 2012 Jan 12; 344:d7642
Is Acetaminophen a Culprit in Asthma?
Positive associations exist between acetaminophen use and asthma in children.
Androgen-Deprivation Therapy and Cardiovascular Mortality
A meta-analysis indicates that ADT does not affect CV mortality and is associated with reduced disease-specific and all-cause mortality in patients with nonmetastatic prostate cancer.
By Robert Dreicer, MD, MS, FACP
December 7, 2011
Covering:
Nguyen PL et al., JAMA 2011 Dec 7; 306:2359
Kelly WK and Gomella LG., JAMA 2011 Dec 7; 306:2382
Is Nasogastric Lavage Beneficial for Acute Gastrointestinal Bleeding?
Gastroenterology Summary and Comment
Free
The procedure increased the likelihood of early endoscopy but not better patient outcomes, such as lower mortality. The question merits prospective analysis.
Does Anti–Tumor Necrosis Factor α Therapy Increase the Risk for Serious Infection?
Dermatology Summary and Comment
In this large cohort study, unlike in most of the previous studies, researchers found no increased risk for serious infections with TNF antagonists.
By Jeffrey P. Callen, MD
November 10, 2011
Covering:
Grijalva CG et al., JAMA 2011 Nov 6
Dixon W and Felson DT., JAMA 2011 Nov 6
Emerging Treatment Options for Severe Acute Alcoholic Hepatitis
Gastroenterology Summary and Comment
Adding <$EMPH_O>N<$EMPH_C>-acetylcysteine to glucocorticoid therapy did not improve 6-month survival. Early liver transplant did, but in a selectively chosen subgroup.
By Atif Zaman, MD, MPH
November 10, 2011
Covering:
Nguyen-Khac E et al., N Engl J Med 2011 Nov 10; 365:1781
Mathurin P et al., N Engl J Med 2011 Nov 10; 365:1790
Brown RS Jr., N Engl J Med 2011 Nov 10; 365:1836
