Shirin Poonja, DO
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Holding Chambers (Spacers) vs. Nebulizers for Acute Asthma
October 27, 2014
Clinical question: Are beta-2 agonists as effective when administered through a holding chamber (spacer) as they are when administered by a nebulizer? Background: During an acute asthma attack, beta-2 agonists must be delivered to the peripheral airways.
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Long-Term Cognitive Impairment after Critical Illness
October 27, 2014
Clinical question: Are a longer duration of delirium and higher doses of sedatives associated with cognitive impairment in the hospital? Background: Survivors of critical illness are at risk for prolonged cognitive dysfunction.
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Endoscopic vs. Surgical Cystogastrostomy for Pancreatic Pseudocyst Drainage
October 27, 2014
Clinical question: How does endoscopic cystogastrostomy for pancreatic pseudocyst drainage compare to the standard surgical approach? Background: Pancreatic pseudocysts are a common complication of pancreatitis and necessitate decompression when they are accompanied by pain, infection, or obstruc
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Single vs. Dual Antiplatelet Therapy after Stroke
October 27, 2014
Clinical question: Is dual antiplatelet therapy more beneficial or harmful than monotherapy after ischemic stroke? Background: It is recommended that patients with ischemic stroke or transient ischemic attack (TIA) receive lifelong antiplatelet therapy; however, there have been insufficient studi
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New Oral Anticoagulants Increase GI Bleed Risk
October 27, 2014
Clinical question: Do thrombin and factor Xa inhibitors increase the risk of gastrointestinal (GI) bleeding when compared to vitamin K antagonists and heparins? Background: New oral anticoagulants (thrombin and factor Xa inhibitors) are available and being used with increased frequency due to equ
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De-Escalating Antibiotics in Sepsis
October 27, 2014
Clinical question: Does tailoring antibiotics based on known pathogens impact mortality for patients with severe sepsis or shock? Background: In patients with sepsis, the use of early empiric antibiotics reduces morbidity and mortality.
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Three-Month Dual Antiplatelet Therapy for Zotarolimus-Eluting Stents
October 27, 2014
Clinical question: Is short-term, dual antiplatelet therapy noninferior to long-term therapy in zotarolimus-eluting stents? Background: Current guidelines recommend long-term (>12 months) dual antiplatelet therapy after the placement of drug-eluting stents.
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Antibiotic Algorithm Can Guide Therapy in Healthcare-Associated Pneumonia
October 27, 2014
Clinical question: Can an algorithm based on risk for multidrug-resistant (MDR) organisms and illness severity guide antibiotic selection in healthcare-associated pneumonia (HCAP)? Background: The 2005 American Thoracic Society/Infectious Diseases Society of America (ATS/IDSA) guidelines identify
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Adults Hospitalized for Respiratory Syncytial Virus Infections Have High Morbidity, Mortality Rates
October 27, 2014
Clinical question: What are the complications and outcomes of respiratory syncytial virus (RSV) infection in adults requiring hospitalization? Background: RSV is a common cause of lower respiratory tract infection in infants and young children, leading to hospitalization and even death.
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ICU Pressures Improve Transfers to the Floor
October 27, 2014
Clinical question: Does ICU strain negatively affect the outcomes of patients transferred to the floor? Background: With healthcare costs increasing and critical care staff shortages projected, ICUs will have to operate under increasing strain.