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OTC Analgesics Not Associated with Acute Decompensation in Cirrhotic Patients
October 27, 2014
Clinical question: Do over-the-counter (OTC) analgesics lead to acute hepatic decompensation among patients with cirrhosis? Background: In theory, intake of acetaminophen and/or nonsteroidal anti-inflammatory drugs (NSAIDs) can worsen hepatic function and lead to complications among cirrhotic pat
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Modified IV Acetylcysteine Infusion Reduces Adverse Effects
October 27, 2014
Clinical question: Does a shorter regimen of IV acetylcysteine reduce adverse effects compared to the standard regimen? Background: Acetaminophen poisoning is common, and recommended treatment is IV acetylcysteine; however, the standard regimen has many adverse effects, including vomiting and ana
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No Mortality Benefit with Treatment of Single Peripheral Pulmonary Emboli
October 27, 2014
Clinical question: Does treatment of single peripheral pulmonary emboli impact mortality and rates of post-discharge venous thromboembolism (VTE)? Background: With the increase in CT pulmonary angiography (CTPA) use the past decade, there has been an increased rate of detection of peripheral fill
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Healthcare-Associated Infections Continue to Impact the U.S. Healthcare System Financially
October 27, 2014
Clinical question: What is the estimated cost of healthcare-associated infections (HAI) to the U.S. healthcare system? Background: In spite of education efforts, HAIs occur frequently and contribute to high healthcare costs in the U.S. This study sought to estimate the costs of HAIs to the U.S.
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Lower Perioperative Mortality with Endovascular Vs. Open Abdominal Aortic Aneurysm Repair
October 27, 2014
Clinical question: How do perioperative and long-term morbidity and mortality compare in endovascular and open repair of abdominal aortic aneurysm (AAA)? Background: Open AAA repair has relatively high perioperative mortality.
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Discontinuation of Beta Blockers Increases Risk of Postoperative Myocardial Infarction and Death
October 27, 2014
Clinical question: Does perioperative beta-blocker discontinuation affect postoperative myocardial infarction (MI) in low-risk patients undergoing joint arthroplasty? Background: Recent trials show no benefit of perioperative beta blockers in reducing the incidence of perioperative myocardial inf
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Cancer Guideline for VTE Prophylaxis for Inpatients and Long-Term Treatment With Low-Molecular-Weight Heparin for Acute VTE
October 27, 2014
Clinical question: On what aspects of VTE management in cancer patients are there consensus among the major guideline panels? Background: VTE is a common and serious complication of cancer.
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Trauma Patients with Pulmonary Embolism Might Not Have DVT on Imaging of Lower Extremities
October 27, 2014
Clinical question: What is the relationship between acute DVT and pulmonary embolism (PE) in trauma patients? Background: Major trauma is associated with an increased risk of acute DVT and PE. It is assumed that the majority of PEs arise from DVTs in the lower extremities.
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Eliminating Adverse Events and Redundant Tests Could Generate U.S. Healthcare Savings
October 27, 2014
Clinical question: Using available data, what is the estimated cost savings of eliminating adverse events and avoiding redundant tests? Background: Reimbursement schemes are changing such that hospitals are reimbursed less for some adverse events.
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High Perioperative Oxygen Fraction Does Not Improve Surgical-Site Infection Frequency after Abdominal Surgery
October 27, 2014
Clinical question: Does the use of 80% oxygen perioperatively in abdominal surgery decrease the frequency of surgical-site infection within 14 days without increasing the rate of pulmonary complications? Background: Low oxygen tension in wounds can negatively impact immune response and healing.