Southern medical journal
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Southern medical journal · Jul 2013
Comparative StudyFibrinolytic therapy versus primary percutaneous coronary interventions for ST-segment elevation myocardial infarction in Kentucky: time to establish systems of care?
Fibrinolytic therapy is recommended for ST-segment myocardial infarctions (STEMI) when primary percutaneous coronary intervention (PPCI) is not available or cannot be performed in a timely manner. Despite this recommendation, patients often are transferred to PPCI centers with prolonged transfer times, leading to delayed reperfusion. Regional approaches have been developed with success and we sought to increase guideline compliance in Kentucky. ⋯ In contemporary treatment of STEMI in Kentucky, ongoing delays to reperfusion therapy remain regardless of treatment strategy. For further improvement in care, acceptance of transfer delays is necessary and institutions should adopt standardized protocols in association with a regional system of care.
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Southern medical journal · Jun 2013
ReviewCan in-hospital urinary catheterization rates be reduced with benefits outweighing the risks?
Urinary catheterization has risks and its use should be limited because it is the main cause of healthcare-associated urinary tract infection. Other risks are the potential for urethral injuries and the possibility that the catheter will be left in permanently. ⋯ A major problem is that the guidelines and criteria for urinary catheterization are inconsistent and open to variable interpretations. More restrictive criteria based on observable patient benefit can reduce rates of urinary catheterization and may improve patient care.