In the Literature

CLINICAL SHORTS

Benzodiazepines Commonly Prescribed to Geriatric Patients

Upon hospital discharge, 3.1% of elderly patients have a new prescription for a benzodiazepine. Half will become chronic users of this risky class of medication.

Citation: Bell CM, Fischer HD, Gill SS, et al. Initiation of benzodiazepines in the elderly after hospitalization. J Gen Intern Med. 2007 Jul;22(7):1024-1029.

Intensive Statin Therapy Appears Beneficial, Safe in Older Patients

A randomized controlled trial in the elderly demonstrates 19% relative risk reduction for major cardiovascular events with high-dose statin therapy compared with low-dose statin treatment.

Citation: Wenger NK, Lewis SJ, Herrington DM, et al. Outcomes of using high- or low-dose atorvastatin in patients 65 years of age or older with stable coronary heart disease. Ann Intern Med. 2007 Jul 3;147(1):1-9.

A Third of Top MI Hospitals Fall Outside Highest Performing Quartile

The “America’s Best Hospitals” for treatment of acute myocardial infarction designation awarded by U.S. News & World Report reflects an overall decreased mortality for patients treated at highly ranked hospitals. Up to a third of the ranked hospitals fell outside the best-performing quartile for risk standardized mortality rates.

Citation: Wang O, Wang Y, Lichtman JH, et al. “America’s Best Hospitals” in the treatment of acute myocardial infarction. Arch Intern Med. 2007 Jul 9;167(13):1345-1351.

Quality of Chest Compressions Most Important Factor for Successful Resuscitation after Cardiac Arrest

In animals resuscitated five minutes after induction of a complete left anterior descending artery occlusion, the adequacy of the chest compressions was the most relevant factor in whether animals were successfully resuscitated. Adequacy of compressions was a more important factor than time to cardioversion or whether cardioversion preceded compressions.

Citation: Ristagno G, Tang W, Yun-Te C, et al. The quality of chest compressions during cardiopulmonary resuscitation overrides importance of timing of defibrillation. Chest. 2007 Jun 5;132(2);70-75.

The Next Chapter in Fluoroquinolone Resistance

In addition to resistance to sulfonamides, tetracyclines, and penicillins, a 16-year multisite sentinel surveillance now demonstrates fluoroquinolone resistant strains of Neisseria gonorrhoeae in 70% of cities.

Citation: Wang S, Harvey AB, Conner SM, et al. Antimicrobial resistance for Neisseria gonorrhoeae in the United States, 1998 to 2003: The spread of fluoroquinolone resistance. Ann Intern Med. 2007 Jul 17;147(2):81-88.

Do Beta-Blockers Slow Progression of Coronary Atherosclerosis?

Although a post-hoc, pooled analysis of individual patient data demonstrated that beta-blockers significantly decrease atheroma volume, this study was limited by significant differences between the treatment and the control groups.

Citation: Sipahi I, Tuzcu EM, Wolski KE, et al. B-blockade and progression of coronary atherosclerosis: Pooled analysis of 4 intravascular ultrasonography trials. Ann Intern Med. 2007 Jul 3;147(1):10-18.