By  | June 29, 2010 |  0
In this large trial of patients with end stage kidney disease, patients were randomized to initiation of dialysis at a GFR of 10-14 or GFR of 5-7. Mean time to dialysis initiation was 1.8 months versus 7.4 months, but there was no difference between the groups (after a median of 3.6 years) in death or […]
By  | June 29, 2010 |  0
In this retrospective cohort of almost 500 patients who died in the hospital, researchers found over half of them were admitted with an end-stage disease, and 15% died during CPR. In assessing 16 quality indicators to assess the quality of the dying experience, they found almost 1/3 of patients did not receive recommended care for […]
By  | June 29, 2010 |  0
In this large retrospective analysis of diagnostic adverse errors, researchers found diagnostic adverse errors accounted for only 6% of all adverse errors, but 83% of these were judged as preventable, and 29% were judged to contribute to death. The primary causes were found to be problems with physician knowledge or information transfer. Continued training in […]
By  | June 25, 2010 |  0
In this prospective cohort 1005 patients scheduled for elective vascular surgery, all had an echo performed. Of all the patients, 21% had asymptomatic diastolic dysfunction, and 19% had asymptomatic systolic dysfunction. After multivariate adjustment, LV dysfunction independently predicted risk of 30 day cardiovascular events (OR 2.3 and 1.8 for systolic and diastolic dysfunction, respectively) and […]
By  | June 25, 2010 |  0
Beta blockers have long thought to be contraindicated in patients with cocaine-associated chest pain. In this retrospective single center analysis of 331 patients with chest pain and cocaine-positive drug screens, almost half received a beta blocker. There was no significant differences in EKG changes or troponin levels between those that did and did not receive […]
By  | June 24, 2010 |  20
After serving on the board of the American Board of Internal Medicine for the past few years, I’ve come to truly appreciate the value of board certification in demonstrating – and enhancing – our competence and commitment to professionalism. But not all boards are created equal: the ABIM, like all the members of the American […]