Archive for February 2010

Hpylori stool tests

In this comparison of the diagnostic accuracy of 3 monoclonal antibody stool tests for Hpylori, sensitivity ranged from 69% to 92%, and specificity ranged from 76% to 90%. The take home message is there is significant variability of diagnostic performance of various Hpylori stool tests, but they all perform better than the older polyclonal tests, and will be used more frequently over time (abstract).

Cutting CA-BSI is sustainable

In this long-term follow up of the effectiveness of a central-line care bundle, originally published in 2006 (abstract), the rate of catheter associated blood stream infections (CA-BSIs) was sustained from 18 months to 36 months of follow up. This is encouraging that such drastic reductions in CA-BSIs can be sustained (abstract)

Incidence of CIN after emergency PCI

In this retrospective cohort of 338 patients undergoing emergency PCI for ACS, 28% developed CIN, which was significantly more common in women, those with an LAD lesion, a contrast volume >200cc, or an end-diastolic pulmonary artery pressure > 15mmHg. Mortality in the CIN group was significantly higher than the non-CIN group (10% vs 3%). CIN is common and associated with high mortality post-emergency PCI. Better peri-procedural management is required to reduce the associated morbidity and mortality (abstract)

Substituting Coffee Cake for Journal Articles: Another Unforeseen Consequence of IT

Late February is the pits for interns – the novelty of being a real-live MD is long gone, and the rebirth of residency is too far beyond the horizon to see. The other day, my wonderful resident Anna brought a coffee cake to my ward team's post-call rounds, partly to psych up the troops. This triggered a funny set of memories, memories of how residents showed their love for their interns and students during my training era, the 1980s. We handed them journal articles! For those of you whose academic mother’s milk is Google Scholar and UpToDate, let me tell you how this went, back in The Day. After receiving our copies of the major journals in the mail (remember mail?), conscientious residents would tear out the full articles that were “keepers,” placing them in manila folders in the ugly steel filing cabinets we all owned. For other articles that…

Multi-disciplinary rounding reduces mortality in ICUs

In this large statewide retrospective database analysis, adjusted ICU mortality was lowest in units which had daily multi-disciplinary rounds. When stratified by intensivist staffing, those with daily rounds and high staffing had the lowest mortality, followed by those with daily rounds and low staffing. Multi-disciplinary rounds are vital to good patient outcomes (abstract)