In this small cohort of 56 patients with left sided endocarditis, of the 40 that underwent brain MRI, 80% had evidence of brain emoblization (48% were subclinical, 33% were clinical stroke). Of those with staph aureus, 95% had evidence of brain embolization. Mortality at 30 days was much higher for those with stroke (46%) and subclinical brain emoblization (32%) than those without brain embolization (0%). Subclinical brain embolization is very common in patients with endocarditis, and is associated with a poor prognosis (abstract).
by Deepak Asudani, MD, MPH, FHM Whether it is the prompt and expeditious international collaboration to develop an Ebola vaccine, or tardy but promising development of the first anti parasitic malarial vaccine or the fascinating technology utilizing synthetic DNA for vaccine development against MERS, these developments promise to highlight significant strides in vaccine development for […]
Economists describe preferences in two ways: revealed and stated. Say, for example, I asked you to implement a penalty program for your team with the goal of decreasing the number of occasions members did not clean their hands after a patient encounter. Because you know bad hands equal bad outcomes, you’re apt to offer up […]
by Eric Howell, MD, SFHM “Tell me what you know about antibiotics.” That’s the discussion I start with hospitalized patients all the time, right after they ask me to prescribe antibiotics for their simple cough, or other viral-like illness. And, from their perspective, asking for antibiotics makes sense. After all, antibiotics have been the physician’s […]