The American journal of the medical sciences
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Infectious disease (ID) clinicians and multidisciplinary teams may have a beneficial impact on patient outcomes. This study was conducted to determine the impact of dedicated ID team rounding in an adult noncardiac intensive care unit (ICU) on antimicrobial costs, length of stay and mortality. ⋯ Institution of dedicated ID team rounding in the ICU leads to substantial decreases in antimicrobial costs, hospital length of stay and inpatient mortality among those patients seen by the team.
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Letter Case Reports
Pomalidomide-Induced Pulmonary Toxicity in Multiple Myeloma.
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Randomized Controlled Trial Multicenter Study
A multicenter, randomized, trial comparing urapidil and nitroglycerin in multifactor heart failure in the elderly.
Multifactor heart failure is a common life-threatening event in elderly patients and often complicated by concomitant hypertension and diabetes mellitus (DM). The aim of this study was to evaluate whether α1-blocker, urapidil, provides additional therapeutic benefits compared to nitroglycerin (NG) in treatment of multifactor heart failure complicated by hypertension and DM in elderly patients. ⋯ Urapidil demonstrated better efficacy than NG on lowering and stabilizing systolic BP, attenuating cardiac afterload and improving cardiac function. Both NG and urapidil significantly reduced FPG levels in multifactor heart failure patients with DM. Urapidil is a therapeutic option for the multifactor heart failure patients complicated with hypertension and DM.
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Percutaneous endoscopic gastrostomy (PEG) tube placement is recommended in amyotrophic lateral sclerosis (ALS) patients with dysphagia to provide reliable access for medications and nutrition. It is preferably done while forced vital capacity (FVC) is greater than 50% of predicted to reduce risk of postprocedural respiratory complications. Percutaneous radiologic gastrostomy has been shown to have higher success rates and lower complication rates compared with PEG. The authors sought to investigate the safety of PEG placement in ALS patients with varying respiratory compromise. ⋯ In conclusion, PEG tube placement in patients with ALS seems to be a safe procedure in patients without significant respiratory compromise. In patients with FVC <50%, based on literature review and the results of this study, the authors recommend percutaneous radiologic gastrostomy over PEG placement.
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Synthetic cannabinoids (SCBs), also known under the brand names of "Spice," "K2," "herbal incense," "Cloud 9," "Mojo" and many others, are becoming a large public health concern due not only to their increasing use but also to their unpredictable toxicity and abuse potential. There are many types of SCBs, each having a unique binding affinity for cannabinoid receptors. Although both Δ-tetrahydrocannabinol (THC) and SCBs stimulate the same receptors, cannabinoid receptor 1 (CB1) and cannabinoid receptor 2 (CB2), studies have shown that SCBs are associated with higher rates of toxicity and hospital admissions than is natural cannabis. ⋯ Acute kidney injury has also been strongly associated with SCB use. Treatment mostly involves symptom management and supportive care. More research is needed to identify which contaminants are typically found in synthetic marijuana and to understand the interactions between different SBCs to better predict adverse health outcomes.