Archive for August 2010

Heading toward flu season…

The CDC has announced an expected 160 million doses of influenza vaccine this year, to be available by the end of September. The single vaccine will incorporate all 3 influenza viruses (including the 2009 H1N1) and will be universally recommended to all adult patients and all healthcare workers (CDC website)

CAM best for delirium assessment

In this systematic review of bedside assessments for delirium in hospitalized patients, the CAM had the best diagnostic accuracy of all tests reviewed, with a positive likelihood ratio of 10 and negative likelihood ratio of 0.2 (abstract).

No need for both CRP and ESR in hospitalized patients

In this retrospective analysis of 5777 hospitalized patients, ESR and CRP "agreed" (both elevated or both normal) in 67% of patients. Of the 33% disagreements, chart review found the majority of disagreements were an elevated ESR and normal CRP, where the CRP more accurately reflected the patient's condition (resolving inflammatory condition or false positive ESR). In suspected inflammatory conditions, CRP is a more accurate measure in hospitalized patients, with fewer false negatives or positives than ESR (abstract)

POLITICO Headline, 1865: Lincoln Saves Union…But Can He Save House Majority.

Public Policy Contributor Brad Flansbaum writes… That line came from none other than Barack Obama at the Whitehouse Correspondents dinner this year, obviously lampooning the glass as half empty, 24/7 news cycle machine. Normally, I accept the tabloid trough feed of the day, the presumed inspiration for the above laugh line, with my usual healthy sense of disdain or merriment. However, a recent slew of postings commenting on the shift in Whitehouse and HHS messaging for the promotion of the new health law preoccupied and bothered me. This type of commentary normally does not get under my skin. I deliberated and was not sure what I found disturbing, the attacks, the methods of ACA promulgation by its architects, or whether the law itself was flawed, meaning “is it as bad as they say it is?” (more…)

Hospitalists managing “Boarder” ED patients

This paper described the role and process of a hospitalist managing patients admitted but boarding in the ED of a large tertiary care hospital. In hospitals with high occupancy rates, ED boarders are a common and vulnerable patient population, the care of which is often fragmented and unpredictable. This program is intriguing and may be feasible for large hospital medicine programs to implement (abstract)