By  | October 31, 2008 |  2
Rolling out a new “product” in a nasty economy is usually a formula for disaster. But last week we held the first-ever “Hospitalist Mini-College,” and it was an rousing success. The idea was this: hospitalists have lots of places to go to hear clinical lectures, and now a few options for leadership training and to […]
By  | October 31, 2008 |  0
In this small single institution study of 159 bacteremic patients, all of which had troponin I sent, 43% were elevated (abstract). Most were minor elevations (96% < 1mcg/L). Not surprisingly, independent risk factors for troponin elevations included renal insufficiency, higher WBC, and septic shock. Troponin elevations were not significantly associated with EKG changes (although not performed in […]
By  | October 30, 2008 |  0
Current recommendations from the ADA (guideline) and Surviving Sepsis Campaign (guideline) advocate for tight glucose control in ICU patients, although this had been a contentious issue. The landmark RCT of surgical ICU patients found signficantly lower mortality, LOS, and organ dysfunction in tight control (BS goal 80-110 mg/dL) (van den berghe) but a similar study in medical ICU […]
By  | October 28, 2008 |  0
Here are some interesting tidbits recently published from the largest prospective cohort of infective endocarditis ever collected (abstract). Causative organisms were Gram positive in 81-88% of cases (3-4% Gram negative, 1-2% fungi or yeast, and 8-13% other / culture negative). MSSA accounted for almost 1/3 of cases, and MRSA accounted for 36% of cases in […]
By  | October 27, 2008 |  0
Sporadic influenza activity is being reported in a handful of states. Follow the CDC map to keep tabs on your local activity (cdc map)
By  | October 24, 2008 |  0
The CDC has confirmed a case of transfusion related anaplasmma phagocytophilum (formerly known as human granulocytic erlichiosis), which is a tickborne rickettsial disease (report). Although a rare event, it is important to recognize that the US blood supply is not routinely screened for tickborne diseases, and that these organisms can survive in refridgerated RBCs. We […]