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CT Scans Reliable Determinants of Blunt Trauma
July 5, 2016
NEW YORK - CT scans identify all clinically significant cervical spine injuries in intoxicated patients with blunt trauma, according to a new study. "I don't think any of the results were particularly surprising to any of us who regularly do trauma care, but what I do think is remarkable about th
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Is It Safe to Discharge a Patient with IDU History, PICC for Outpatient Antimicrobial Therapy?
July 4, 2016
Case A 42-year-old female with a history of intravenous (IV) drug use presents with severe neck pain, gait instability, and bilateral C5 motor weakness. A cervical MRI shows inflammation consistent with infection of her cervical spine at C5 and C6 and significant boney destruction.
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LETTER: Point-of-Care Ultrasound: The (Sound) Wave of the Future for Hospitalists
July 3, 2016
Small devices carried in pockets during rounds can enable hospitalists to make quick decisions at the bedside, enhance and teach physical exam skills, streamline patient flow through the hospital, and potentially avoid the cost and risk of exposure to radiation.
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Metformin Continues to Be First-Line Therapy for Type 2 Diabetes
July 1, 2016
Clinical question: Which medications are most safe and effective at managing type 2 diabetes? Background: Patients and practitioners need an updated review of the evidence to select the optimal medication for type 2 diabetes management. Study design: Systematic review. Synopsis: The authors
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Reevaluating Cardiovascular Risk after TIA
July 1, 2016
Clinical question: What is the prognosis of patients who have a TIA or minor stroke? Background: Prior studies had estimated the risk in the three months following a TIA or minor stroke of having a stroke or acute coronary syndrome (ACS) as 12% to 20%, but this may not reflect the risk of modern
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New HCV Diagnostic Tests Provide Accuracy and Low Costs
June 27, 2016
NEW YORK - Several hepatitis C virus core antigen (HCVcAg) tests accurately diagnose hepatitis C virus (HCV) infection and could replace nucleic acid testing (NAT) in settings where HCV is prevalent, according to a systematic review and meta-analysis. "Overall, several of the tests perform very w
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Single Dose of Dexamethasone Not an Alternative to ‘Steroid Burst’ for Acute Asthma Treatment
June 27, 2016
Clinical question: Is one dose of dexamethasone comparable to five days of prednisone for treating mild-to-moderate asthma exacerbations? Background: Corticosteroids are the mainstay of initial treatment for asthma exacerbations.
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High-Flow Oxygen after Extubation Reduces Reintubation
June 27, 2016
Clinical question: Does nasal high-flow (NHF) oxygen after extubation reduce reintubation rates in low-risk patients? Background: NHF oxygen devices deliver warmed and humidified oxygen up to 60 liters per minutes. NHF provides positive end-expiratory pressure and dead-space washout.
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Tips Toward Better Clinical Summaries
June 26, 2016
“I recently discharged a complex patient from the hospital, and I was shocked to see the poor quality of his clinical summary,” says Erin Sarzynski, MD, MS, of Michigan State University’s Department of Family Medicine.
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Interhospital Transfer Handoff Practice Variance at U.S. Tertiary Care Centers
June 24, 2016
Clinical question: How do interhospital handoff practices differ among U.S. tertiary care centers, and what challenges and innovations have providers encountered? Background: Little has been studied regarding interhospital transfers.