Archives of internal medicine
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Comparative Study
Infection acquisition following intensive care unit room privatization.
Patients in intensive care units (ICUs) often acquire infections, which impose a heavy human and financial burden. The use of private rooms may reduce the acquisition of certain pathogens, but the limited evidence on this topic is inconsistent. ⋯ Conversion to single rooms can substantially reduce the rate at which patients acquire infectious organisms while in the ICU.
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Communication between primary care physicians (PCPs) and specialists regarding referrals and consultations is often inadequate, with negative consequences for patients. We examined PCPs' and specialists' perceptions of communication regarding referrals and consultations. We then identified practice characteristics associated with reported communication. ⋯ These modifiable practice supports associated with communication between PCPs and specialists can help inform the ways that resources are focused to improve care coordination.
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It has become standard practice in medical journals to require authors to disclose their relationships with industry. However, these requirements vary among journals and often lack specificity. As a result, disclosures may not consistently reveal author-industry ties. ⋯ Current journal disclosure practices do not yield complete or consistent information regarding authors' industry ties. Medical journals, along with other medical institutions, should consider new strategies to facilitate accurate and complete transparency.
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Clinical practice guidelines are developed to assist in patient care. Physicians may assume that following such guidelines means practicing evidence-based medicine. However, the quality of supporting literature can vary greatly. ⋯ More than half of the current recommendations of the IDSA are based on level III evidence only. Until more data from well-designed controlled clinical trials become available, physicians should remain cautious when using current guidelines as the sole source guiding patient care decisions.
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Methicillin-resistant Staphylococcus aureus (MRSA) wound infections after cardiac surgery have increased in recent years and carry significant morbidity and mortality. In our hospital, MRSA accounted for 56% of postoperative infections. ⋯ This MRSA intervention program, in which all patients receive intranasal mupirocin and patients colonized with MRSA receive vancomycin prophylaxis, has resulted in a near-complete and sustained elimination of MRSA wound infections after cardiac surgery.