By  | September 29, 2012 |  0
This systematic review of clinical trials of the use of vaptans (tolvaptan, satavaptan, and lixivaptan) in patients with cirrhosis and hyponatremia found no difference in mortality, variceal bleeding, hepatic encephalopathy, SBP, hepatorenal syndrome, or renal failure, compared to placebo. The use of vaptans did increase serum sodium and reduced weight, but also increased the risk […]
By  | September 29, 2012 |  0
In this large observational cohort of Medicare patients, the volume of total knee arthroplasty (TKA) increased 162% from 1991 to 2010, while revisions increased 106%. Length of stay dropped from 7.9 to 3.5 days, and 30 day readmissions increased from 4.2% to 5.0%. These increases bode well for hospitalist co-management services (abstract)
By  | September 29, 2012 |  0
In patients with Afib and CAD requiring anti platelet therapy, optimal anticoagulation is unknown. In this cohort, bleeding rates were 14/100 person years with triple therapy (warfarin + 2 anti platelets), ~7-11/100 person years for any dual therapies, and ~6-7/100 person years for any mono therapy. Compared to dual therapy, triple therapy was not associated […]
By  | September 29, 2012 |  0
In this systematic review of patients post-ACS on anti platelet therapy, the use of newer oral anticoagulants (rivaroxaban, apixaban, dabigatran) was associated with much higher risk of bleeding (odd ratio 3, CI 2.2 to 4.2), a moderate reduction in stent thrombosis/ischemia, and no overall change in mortality, compared to placebo. The overall net benefit of […]
By  | September 29, 2012 |  0
According to a survey by the CDC, 86% of physicians and 78% of nurses received a flu vaccine during last flu season. Vaccine rates were 95% among healthcare workers in hospitals that required the vaccine. The most common reasons cited for not getting vaccinated included the belief that it was not necessary, and concerns about […]
By  | September 29, 2012 |  0
In this before-after observational cohort of surgical ICU patients with suspected infection, those that received aggressive antibiotics (started with suspected infection after cultures were sent) had significantly higher adjusted mortality (odds ratio 2.5, CI 1.5 to 4.0) compared to those that received conservative antibiotics (started only after objective confirmation of infection) . The conservative antibiotic group […]