A January 10, 2017 JAMA Viewpoint article looks at Altmetrics. The article makes note that there are over 2.5 million articles published every year and the number of articles in the literature more than doubles every decade. Clearly differentiating the relevant from the irrelevant is crucial. Typically, the influence of a published article would primarily… Read More
This cohort study in the January 17, 2017 issue of JAMA looks at the Prognostic Accuracy of Sepsis-3 Criteria for In-Hospital Mortality Among Patients With Suspected Infection Presenting to the Emergency Department The study concluded that the quick Sequential Organ Failure Assessment (qSOFA) score is better than the systemic inflammatory response syndrome (SIRS) or severe… Read More
THis JAMA Internal Medicine article concludes that states that have medical marijuana have lower opiate overdose death rates. It is no secret that the number of patients with noncancer pain who receive opiate prescriptions has nearly doubled in the past decade. As this has occurred, the number of opiate overdoses and deaths has similarly peaked. … Read More
The US Preventive Services Task Force (USPSTF) recommends use of low- to moderate-dose statins for primary prevention in adults aged 40 to 75 years who have 1 or more CVD risk factors (dyslipidemia, diabetes, hypertension, or smoking) and a calculated 10-year CVD event risk of 10% or greater (B recommendation). The USPSTF also recommends that clinicians… Read More
As residents we were always taught not to extubate at night. This JAMA cohort study examined the frequency of overnight extubations and their outcomes. This study looked at 97 844 patients in US intensive care units who were intubated. They found 20.1% were extubated at night. The study extended from January 1, 2015, to July 5,… Read More
This November 4, 2016 New York Times Article talks about how Community paramedicine programs are expanding and are increasingly tending to older patients in their homes, solving problems there and eliminating costly ambulance trips. In 2009, when Medstar Mobile Healthcare began enrolling patients in Fort Worth, it was one of four emergency services in the… Read More
This JAMA article discusses the problems of routinely hospitalizing elderly patients which may hasten their disability, independence, and demise In older patients, acute medical illness that requires hospitalization is a sentinel event that often precipitates disability. This results in the subsequent inability to live independently and complete basic activities of daily living (ADLs). This hospitalization-associated… Read More
This JAMA article goes contrary to the thinking that post resuscitation hypothermia is good. The Key Points Question Is therapeutic hypothermia associated with better survival outcomes for patients with in-hospital cardiac arrest? Findings In this cohort study using a US national registry, survival outcomes were compared for 26 183 patients who were treated vs not treated… Read More
Opiate abuse is a nationwide epidemic. We are constantly looking for solutions One might be using buprenorphine implants. This study in JAMA found that the implants were as successful as sublingual buprenorphine/naloxone in maintaining clinical stability in opioid-dependent patients. During the 6-month study period, 63% of patients in the buprenorphine implant group and 54% of… Read More
