Archive for March 2011

Statins associated with better ICH outcomes

In this meta-analysis of patients with ICH, those who had been on a statin before the ICH had twice the odds of better functional outcomes, and half the odds of mortality at 90 days, compared to those not on a statin before the ICH. Although not a randomized trial, this study adds mounting evidence of a neuro-protective effect of statins (abstract)

Tiotropium reduces COPD exacerbations better than salmeterol

In this 1 year randomized trial of patients with moderate to severe COPD, those randomized to tiotropium had significantly fewer COPD exacerbations and overall hospitalizations than those randomized to salmeterol. For patients with moderate to severe COPD, tiotropium may be better than salmeterol in reducing exacerbations and hospitalizations (abstract)

Nursing home quality and litigation

In this large retrospective analysis of five large nursing home chains, those with higher quality scores on 10 measures were only marginally less likely to to have a tort claim filed, than those with the lowest scores. There is not a strong association between nursing home quality and litigation claims in the US (abstract)

Dabigatran storage and handling

The FDA has released important information on the requirements for storage and handling of dabigatran; it has to be stored in the bottle in which it comes (not in a pill box, due to degradation of the product), and has to be used within 60 days of opening. Patients on dabigatran should be counseled not to put the pills into anything other than the original container (FDA site)

HOSPITALISTS AND THE NURSES UNION-PICK YOUR SIDE

I fondly remember attending the Local 17 insulators union hall meetings with my dad when I was a young boy. The scene was similar to what one might expect: a smokey, comfortably packed, dimly lit and musty room in a small red brick building in Chicago's "Back of the Yards" neighborhood.  My father  introduced every "Brother" to me as "Mr. Jones, or Mr. Murphy, etc..." My dad seemed very comfortable in that environment as did I.  Those memories validate a sense of feeling very safe and very welcomed... taken care of, if you will. Later in life, I worked  my way through college and medical school by removing the same asbestos insulation that my father and his Brethren of Local 17 installed decades earlier. (Local 17 ironically boomed in the 80's during the asbestos abatement era). I frequently heard that many of those "Misters" I had met in my youth…
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