Masih Shinwa, MD
Article
Hydrocortisone reduces mortality in severe CAP
June 3, 2024
Clinical question: Does early hydrocortisone therapy reduce mortality among patients with severe community-acquired pneumonia (CAP) requiring admission to an intensive care unit (ICU) or intermediate...
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Postoperative Clostridium Difficile Infection Associated with Number of Antibiotics, Surgical Procedure Complexity
April 8, 2016
Clinical question: What are the factors that increase risk of Clostridium difficile infection (CDI) in postoperative patients? Background: CDI has become an important infectious etiology for morbidity, lengthy and costly hospital admissions, and mortality.
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Most Postoperative Readmissions Due to Patient Factors
April 8, 2016
Clinical question: What is the etiology of 30-day readmissions in postoperative patients? Background: As the focus of healthcare changes to a quality-focused model, readmissions impact physicians, reimbursements, and patients.
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Ischemic Hepatitis Associated with High Inpatient Mortality
April 4, 2016
Clinical question: What is the incidence and outcome of patients with ischemic hepatitis? Background: Ischemic hepatitis, or shock liver, is often diagnosed in patients with massive increase in aminotransferase levels most often exceeding 1000 IU/L in the setting of hepatic hypoperfusion.
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AIMS65 Score Helps Predict Inpatient Mortality in Acute Upper Gastrointestinal Bleed
April 1, 2016
Clinical question: Does AIMS65 risk stratification score predict inpatient mortality in patients with acute upper gastrointestinal bleed (UGIB)? Background: Acute UGIB is associated with significant morbidity and mortality, which makes it crucial to identify high-risk patients early.
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No Mortality Benefit to Cardiac Catheterization in Patients with Stable Ischemic Heart Disease
March 28, 2016
Clinical question: Can cardiac catheterization prolong survival in patients with stable ischemic heart disease? Background: Previous results from the COURAGE trial found no benefit of percutaneous intervention (PCI) as compared to medical therapy on a composite endpoint of death or nonfatal myoca
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Increase in Broad-Spectrum Antibiotics Disproportionate to Rate of Resistant Organisms
March 28, 2016
Clinical question: Have healthcare-associated pneumonia (HCAP) guidelines improved treatment accuracy? Background: Guidelines released in 2005 call for the use of broad-spectrum antibiotics for patients presenting with pneumonia who have had recent healthcare exposure.
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Discontinuing Inhaled Corticosteroids in COPD Reduces Risk of Pneumonia
March 25, 2016
Clinical question: Is discontinuation of inhaled corticosteroids (ICSs) in patients with COPD associated with a decreased risk of pneumonia? Background: ICSs are used in up to 85% of patients treated for COPD but may be associated with adverse systemic side effects including pneumonia.
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MEDS Score for Sepsis Might Best Predict ED Mortality
March 25, 2016
Clinical question: Which illness severity score best predicts outcomes in emergency department (ED) patients presenting with infection? Background: Several scoring models have been developed to predict illness severity and mortality in patients with infection.
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Continuous Chest Compressions Do Not Improve Outcome Compared to Chest Compressions Interrupted for Ventilation
March 18, 2016
Clinical question: In cardiopulmonary resuscitation, do continuous chest compressions improve survival or neurologic outcome compared to chest compressions interrupted for ventilation? Background: Animal models have demonstrated that interruptions in chest compressions are associated with decreas
