Sepsis drives far more readmissions than we realized

Sepsis may contribute to far more hospital readmissions than previously recognized -- more than any other monitored condition. Recognition of this by federal and private payers could result in increased intensity of oversight of health teams' care delivery for patients with sepsis. Hospital readmissions are squarely in the sights of the Centers for Medicare and Medicaid [... read more]

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Heparin prophylaxis no help after knee arthroscopy or leg casting (POT-KAST, POT-CAST)

Low molecular weight heparin (LMWH) at preventive doses after arthroscopic knee surgery or leg casting did not prevent venous thromboembolism (DVT or PE), in two Dutch randomized trials. The study helps fill a large gap in knowledge regarding risks and benefits of prophylactic anticoagulation in patients undergoing these procedures. In one (POT-KAST), 1,543 patients received [... read more]

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Video laryngoscopy was no better than directly intubating in the ICU, and may have been worse (MACMAN)

Video laryngoscopy provides beautiful video close-up views of the larynx, by navigating a sensor past the tongue and pharyngeal tissues that can obstruct direct laryngoscopy views. These visual advantages led to its wide adoption by anesthesiologists, emergency physicians, and intensivists after video laryngoscopy's introduction in the late 1990s. The intuition that better visualization must result in improved intubation rates [... read more]

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Fleischner Society Guideline Update 2017: Management of Solid Pulmonary Nodules

Updated 2017 Fleischner Society guidelines advise a less intensive approach to the management of most small pulmonary nodules incidentally discovered on CT scans. The Fleischner Society now recommends that solid nodules 6 mm or less in diameter in low-risk adults >35 years old generally need no further follow-up. In higher-risk patients, a follow-up CT scan should [... read more]

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Can early warning systems predict (and prevent) cardiac arrest?

The increasingly data-saturated modern health care milieu has been catnip to technologists and statisticians. If only we could manage and analyze the data better (as this appealing narrative has it) we could improve health outcomes in the hospital. Predictive modeling algorithms promise to detect patients' impending deterioration and cardiac arrest at an early preventable moment, better than [... read more]

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