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Hospital-Based Medicine

News, opinions and meeting coverage in hospital-based medicine.

Humans Beat Stroke Scales for ICH Prognosis

PHILADELPHIA -- Physicians and nurses in stroke units more accurately predicted outcomes in patients with intracerebral hemorrhage (ICH) compared with common prognostic scales, a researcher reported here.

APA Meeting Highlights Mental Health Biology

NEW YORK CITY -- The biological basis for normal and abnormal mental function is emerging as a dominant theme in psychiatry research, and the American Psychiatric Association annual meeting that starts here Saturday won't be an exception.

Bed Rest in Pregnancy Raises Diabetes Risk

CHICAGO -- Women who are prescribed long-term bed rest for troubled pregnancies are at increased risk of developing gestational diabetes, researchers said here.

Prime Time: No Annual Exams? No Way, SGIM Members Say

SAN DIEGO -- A recommendation from the Society of General Internal Medicine (SGIM) to do away with annual checkups for asymptomatic adults evoked strong emotions in its membership.

CardioBuzz: Is Marijuana Bad for Your Heart?

Whether marijuana actually causes cardiovascular problems remains unclear, a situation that was not necessarily helped by a study based on 35 reports of cannabis-related complications in France, a country with about 1.2 million recreational users.

Missed Doses Cripple Postop DVT Prevention

Missed doses of prophylactic anticoagulation account for much of the deep vein thrombosis that occurs in surgery and trauma patients, a study showed.

Fatty Liver Tied to Diabetes, Atherosclerosis

LONDON -- Non-alcoholic fatty liver disease (NAFLD) is an independent predictor of both type 2 diabetes and carotid atherosclerosis, according to two studies presented here at the annual meeting of the European Association for the Study of the Liver.

How to Replace IV Nitroglycerin in the Shortage

What are the alternatives for IV nitroglycerin in the emergency setting as the shortage saps reserves? Several experts share their thoughts.

ACC: Metformin No Help in MI Recovery

WASHINGTON -- Metformin started soon after reperfusion in the acute setting didn't help cardiac function recover in nondiabetic heart attack patients, a trial showed.

ACC: Gout Drug Tames the Heart

WASHINGTON -- Colchicine may be as effective at reducing multiple recurrences of pericarditis as it is in treating acute episodes and first recurrences.

ACC: Still No Clear CHOICE for TAVI

WASHINGTON -- Head-to-head comparison of transcatheter aortic valve implantation (TAVI) devices favored the second-generation Sapien XT over CoreValve, although the trial was criticized on several fronts.

ACC: CoreValve Bests Surgery

WASHINGTON -- Transcatheter aortic valve implantation (TAVI) with the CoreValve device improved survival compared with surgery in the high-risk pivotal trial cohort.

In AKI, Dialysis Works Better With Higher Creatinine

For patients with acute kidney injury, dialysis is associated with better survival among those with higher creatinine levels, but higher mortality for those with lower levels, researchers found.

10 Ways to Safely Push Ketamine in the ED

A doctor recently took me on a Special K trip, and I enjoyed it immensely.

Early Preeclampsia Often Overlooked

Clinicians wait too long before diagnosing and treating preeclampsia, a hesitance that can be costly, according to an anesthesiologist who serves on a California preeclampsia task force.

Top 5 Reasons Cardiologists Get Sued

Problems with diagnosis -- failing to make one, making the wrong one, or taking too long to get to one -- lead the list of reasons behind cardiology-related lawsuits, revealed closed claims data from a medical malpractice insurer.

Bupivacaine Formula Cuts Narcotic Use

NEW ORLEANS -- A long-lasting formulation of the analgesic bupivacaine (Exparel) can do as good a job reducing post-surgical pain among knee replacement patients as continuous femoral nerve blocks, researchers said here.

Stroke Rounds: Early Surgery Looks Safe After tPA

Performing carotid endarterectomy or stenting in patients who were recently treated with thrombolytic therapy for an acute stroke appeared to be safe, an observational study showed.

CT Appears Safe in Patients With Pacemakers, ICDs

Patients with cardiac rhythm management devices showed no clinically significant major or minor events related to computed tomography imaging over a 10-year period at two large-volume care centers, researchers reported.

ICD-10 Follies: The Birds

Yes, there's a code for that. To mark the forthcoming move to the ICD-10 coding system, 番茄社区 is spotlighting some of those thousands of new codes that might just be getting a bit too granular.

ER Briefs: DIY Laptop to AED Kit -- Good Idea?

Inventors aim to resurrect laptops and tablets as AEDs. We asked Clifton Callaway, MD, PhD, an emergency medicine doctor who heads up EM research at the University of Pittsburgh, to weigh in.

Drug Combo Saves Kids' Tonsils in Mild OSA

The anti-inflammatory asthma drug montelukast (Singulair) plus corticosteroids was an effective initial alternative to surgery for mild obstructive sleep apnea (OSA) in children, a retrospective study showed.

Prime Time: When Athletes Need Drugs

The governing bodies of elite sports keep a strict eye on the use of all kinds of substances to ensure a level playing field for competitive athletes. Here's what you need to know if one of them walks in to your practice in need of treatment.

CardioBuzz: More Money Needed for Heart Research?

The NIH dedicates a lot of money for research into heart disease and stroke, but it still might not be enough, a new study suggested.

10 Questions: E. Wesley Ely, MD, MPH

What's the biggest barrier to practicing medicine today? That's just the first of the 10 Questions the 番茄社区 staff is asking leading clinicians and researchers to get their personal views on their chosen profession. In this series we share their uncensored responses. Here, answers from pulmonary and critical care expert E. Wesley Ely, MD, MPH.

A Brain-Dead Mother, a Million-Dollar Baby

The costs associated with maintaining a pregnant, brain-dead, Texas woman on life support until her fetus is viable are likely to approach $1 million, and long-term costs could easily top $1.5 million.

FDA Rules Differ for OTC vs. POC Glucose Monitors

The FDA has released two draft guidances that establish a line between over-the-counter and point-of-care blood glucose monitors.

Testosterone Level Affects Flu Shot Response

Men with high testosterone and a certain genetic cluster may not experience an antibody response after a flu shot, researchers suggested -- a finding that could affect men taking prescription testosterone.

EMTs Can Give Positive Pressure Ventilation

Out-of-hospital noninvasive positive-pressure ventilation in patients with severe respiratory distress significantly reduced rates of inhospital mortality and need for invasive ventilation, researchers found.

What Bystanders Should Know About CPR -- and Why

Bystander-initiated cardiopulmonary resuscitation (CPR) has poor neurological outcome, and this is true even when bystanders are family members, which suggests deficits in public CPR training.

FDA: Nipple Test No Substitute for Mammogram

A nipple aspirate test shouldn't take the place of mammography or otherwise be used on its own to screen for breast disease, the FDA warned.

Gene Therapy Works in SCID With No Risk of Leukemia

NEW ORLEANS -- Genetic therapy appeared to restore the immune system of patients with X-linked severe combined immunodeficiency (SCID), but without leading to leukemia as a side effect, researchers reported here.

Satisfaction With Epilepsy Surgery Lasts Long Term

WASHINGTON -- More than 90% of patients who had surgery for drug-resistant epilepsy said it was worthwhile when interviewed up to 20 years later, even when quality-of-life indicators were not improved, researchers said here.

Diabetes: TAVI Trumps Heart Surgery

Patients with diabetes who had aortic stenosis fared better in terms of mortality and kidney function during the first year if they underwent transcatheter aortic valve implantation (TAVI) rather than surgery, a post-hoc analysis found.

Radiation Safe in Unbiopsied Lung Cancer

CHICAGO -- Treating people with stereotactic body radiation for suspected -- but unbiopsied -- lung cancers appears to allow for acceptable local control of the disease with low toxicity, researchers reported here.

Use of Expired Auto-Injectors OK'd by FDA

WASHINGTON -- The FDA cautioned emergency medical staff to retain recently expired auto-injectors by Meridian Medical Technologies and to use them in emergencies if no other product is available.

FDA Flags Risk of Nuclear Stress Test Drugs

SILVER SPRING, Md. -- Two agents used in cardiac nuclear stress tests may carry a greater risk of heart attack and death than previously believed, the FDA said Wednesday.

Fast-Acting AMA Group Hopes to Fix SGR

NATIONAL HARBOR, Md. -- A large coalition of American Medical Association members met in seclusion Sunday morning here at the interim meeting of the House of Delegates and rapidly found consensus on a proposed resolution for the repeal of Medicare's sustainable growth rate (SGR) formula.

Rape Laws Offer Little Protection

BOSTON -- The world over, laws to protect rape victims are paper tigers, often enacted but rarely enforced, a researcher said here.

Prime Time: Skin Docs Name 5 Unnecessary Procedures

The American Academy of Dermatology joined more than 80 other medical societies in the Choosing Wisely campaign, naming five treatments or procedures that may not be necessary. Prime Time is a blog by Chris Kaiser for those interested in primary care.

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