Comments for Virtual Journal Club http://beckerinfo.net/JClub Division of Hospital Medicine Virtual Journal Club Mon, 21 May 2012 14:00:28 +0000 hourly 1 http://wordpress.org/?v=3.2.1 Comment on Outcome of Noncardiac and Nonvascular Surgery in Patients With Mechanical Heart Valves. by Robert Mahoney http://beckerinfo.net/JClub/2012/05/18/outcome-of-noncardiac-and-nonvascular-surgery-in-patients-with-mechanical-heart-valves/comment-page-1/#comment-3400 Robert Mahoney Mon, 21 May 2012 14:00:28 +0000 http://beckerinfo.net/JClub/?guid=a6b517d2e3545193ad93d4178323c5e4#comment-3400 This study looked at outcomes of patients with mechanical valves being "bridged" with enoxaparin. Despite practice guidelines supporting the use of enoxaparin for bridging (see http://bit.ly/enoxa), many institutions still rely on unfractionated heparin, prolonging length of stay. How do you "bridge" your mechanical valve patients for procedures? This study looked at outcomes of patients with mechanical valves being “bridged” with enoxaparin. Despite practice guidelines supporting the use of enoxaparin for bridging (see http://bit.ly/enoxa), many institutions still rely on unfractionated heparin, prolonging length of stay.

How do you “bridge” your mechanical valve patients for procedures?

]]> Comment on How long should peripherally inserted central catheterization be delayed in the context of recently documented bloodstream infection? by Robert Mahoney http://beckerinfo.net/JClub/2012/05/05/how-long-should-peripherally-inserted-central-catheterization-be-delayed-in-the-context-of-recently-documented-bloodstream-infection/comment-page-1/#comment-3371 Robert Mahoney Wed, 09 May 2012 16:16:03 +0000 http://beckerinfo.net/JClub/?guid=9c713dd93ead1739aed66f1147a03004#comment-3371 Most patients with bacteremia (particularly with line infections) will need to have central vascular access placed for long-term (2-6 weeks) IV antibiotics. Typically, IV antibiotics are administered initially via short-term peripheral IV in the hospital until central access can be placed, at which point the patient can be discharged if otherwise stable. There is concern that if the central access is placed too soon after bacteremia, the new access will become infected. How long do you typically wait before placing central access after documented bacteremia? Most patients with bacteremia (particularly with line infections) will need to have central vascular access placed for long-term (2-6 weeks) IV antibiotics. Typically, IV antibiotics are administered initially via short-term peripheral IV in the hospital until central access can be placed, at which point the patient can be discharged if otherwise stable. There is concern that if the central access is placed too soon after bacteremia, the new access will become infected.

How long do you typically wait before placing central access after documented bacteremia?

]]> Comment on Do timely outpatient follow-up visits decrease hospital readmission rates? by Robert Mahoney http://beckerinfo.net/JClub/2012/05/04/do-timely-outpatient-follow-up-visits-decrease-hospital-readmission-rates/comment-page-1/#comment-3364 Robert Mahoney Mon, 07 May 2012 16:13:21 +0000 http://beckerinfo.net/JClub/?guid=3533bd0a954f97c7146660e82427c21d#comment-3364 In this study out of Mayo, risk of 30d readmission was no different among patients with follow-up scheduled within 14 days of discharge, more than 14 days after discharge, or not at all. There was a slightly (not statistically but perhaps clinically significant) increased length of stay among those who followed up within 14 days, which may have negatively affected the readmission rate in the <14 day group (if length of stay is positively correlated with readmission). Furthermore, the demographics of the study population do not reflect national patterns. Is there enough evidence to support the "discharge clinics" that are becoming so popular among hospitals to prevent early readmission? In this study out of Mayo, risk of 30d readmission was no different among patients with follow-up scheduled within 14 days of discharge, more than 14 days after discharge, or not at all. There was a slightly (not statistically but perhaps clinically significant) increased length of stay among those who followed up within 14 days, which may have negatively affected the readmission rate in the <14 day group (if length of stay is positively correlated with readmission). Furthermore, the demographics of the study population do not reflect national patterns.

Is there enough evidence to support the “discharge clinics” that are becoming so popular among hospitals to prevent early readmission?

]]> Comment on Refusal of ICU Admission Due to a Full Unit: Impact on Mortality. by Robert Mahoney http://beckerinfo.net/JClub/2012/02/22/refusal-of-icu-admission-due-to-a-full-unit-impact-on-mortality/comment-page-1/#comment-2976 Robert Mahoney Thu, 23 Feb 2012 17:08:58 +0000 http://beckerinfo.net/JClub/?guid=87f70b6a457fabc62cee1d1c40c56423#comment-2976 What is your institution's policy on accepting or refusing ICU admissions? Do you feel that your ICU is large enough to accommodate demand? What is your institution’s policy on accepting or refusing ICU admissions? Do you feel that your ICU is large enough to accommodate demand?

]]> Comment on Pre-Operative Serum Brain Natriuretic Peptide and Risk of Acute Kidney Injury after Cardiac Surgery. by Professor A. KOSSAIFY http://beckerinfo.net/JClub/2012/02/11/pre-operative-serum-brain-natriuretic-peptide-and-risk-of-acute-kidney-injury-after-cardiac-surgery/comment-page-1/#comment-2787 Professor A. KOSSAIFY Sun, 12 Feb 2012 16:43:11 +0000 http://beckerinfo.net/JClub/?guid=400889234ed3a5387dae39e4a1a63461#comment-2787 The article regarding BNP post cardiac surgery is relevant with real practice : low output status related to congestion explains in fact prerenal kidney dysfunction in this setting The article regarding BNP post cardiac surgery is relevant with real practice : low output status related to congestion explains in fact prerenal kidney dysfunction in this setting

]]> Comment on FAQs by Robert Mahoney http://beckerinfo.net/JClub/faqs/comment-page-1/#comment-2686 Robert Mahoney Mon, 30 Jan 2012 16:14:46 +0000 http://beckerinfo.net/JClub/faqs/#comment-2686 The Virtual Journal Club collects abstracts from journals published elsewhere to allow for review and discussion. There are no original articles included. Many of the articles are from peer-reviewed journals, although that is not a requirement for inclusion in the Journal Club. All of the abstracts are aggregated from PubMed, which allows access to some of the powerful features of PubMed (including full-text links and links to similar articles). You are welcome to post comments on any articles on the Journal Club. Comments are moderated but are not peer-reviewed; if a comment is accepted, it is not edited (but it may be moved to another place on the site). Comments can be detailed and can include references to other literature. Good luck, and thanks for asking! The Virtual Journal Club collects abstracts from journals published elsewhere to allow for review and discussion. There are no original articles included. Many of the articles are from peer-reviewed journals, although that is not a requirement for inclusion in the Journal Club. All of the abstracts are aggregated from PubMed, which allows access to some of the powerful features of PubMed (including full-text links and links to similar articles).

You are welcome to post comments on any articles on the Journal Club. Comments are moderated but are not peer-reviewed; if a comment is accepted, it is not edited (but it may be moved to another place on the site). Comments can be detailed and can include references to other literature. Good luck, and thanks for asking!

]]> Comment on FAQs by antoine KOSSAIFY http://beckerinfo.net/JClub/faqs/comment-page-1/#comment-2685 antoine KOSSAIFY Mon, 30 Jan 2012 15:52:20 +0000 http://beckerinfo.net/JClub/faqs/#comment-2685 Dear Editor Are journals peer-reviewed ? and indexed in Pubmed ? If yes, how to proceed to submit an article ? Best regards AK Dear Editor
Are journals peer-reviewed ? and indexed in Pubmed ?
If yes, how to proceed to submit an article ?

Best regards
AK

]]> Comment on Intensive glycaemic control for patients with type 2 diabetes: systematic review with meta-analysis and trial sequential analysis of randomised clinical trials. by Mark Thoelke http://beckerinfo.net/JClub/2011/11/27/intensive-glycaemic-control-for-patients-with-type-2-diabetes-systematic-review-with-meta-analysis-and-trial-sequential-analysis-of-randomised-clinical-trials/comment-page-1/#comment-2276 Mark Thoelke Fri, 02 Dec 2011 00:17:27 +0000 http://beckerinfo.net/JClub/?guid=0acadef9471d393190678363218f2c44#comment-2276 It is amazing how the how fast 'tight control' was promoted without evidence. There is no data to support tight control during hospitalization outside the ICU, and evidence that it is harmful in the ICU, yet it is still promoted the by Society of Hospital Medicine. It is amazing how the how fast ‘tight control’ was promoted without evidence. There is no data to support tight control during hospitalization outside the ICU, and evidence that it is harmful in the ICU, yet it is still promoted the by Society of Hospital Medicine.

]]> Comment on How to Access Full-text Articles by prachi shete http://beckerinfo.net/JClub/how-to-access-full-text-articles/comment-page-1/#comment-2169 prachi shete Sun, 20 Nov 2011 07:22:46 +0000 http://beckerinfo.net/JClub/?page_id=12193#comment-2169 thanks thanks

]]> Comment on Natural history of eosinophilic gastroenteritis. by viswanath reddy http://beckerinfo.net/JClub/2011/08/04/natural-history-of-eosinophilic-gastroenteritis/comment-page-1/#comment-1959 viswanath reddy Mon, 24 Oct 2011 13:17:23 +0000 good observations need full article good observations
need full article

]]> Comment on Hepatic incidentalomas. by naing naing http://beckerinfo.net/JClub/2011/02/22/hepatic-incidentalomas/comment-page-1/#comment-1872 naing naing Mon, 29 Aug 2011 07:08:21 +0000 very nice for online learners very nice for online learners

]]> Comment on Safety and Efficacy of the Oral Direct Factor Xa Inhibitor Apixaban in Japanese Patients With Non-Valvular Atrial Fibrillation. by Akul http://beckerinfo.net/JClub/2011/06/17/safety-and-efficacy-of-the-oral-direct-factor-xa-inhibitor-apixaban-in-japanese-patients-with-non-valvular-atrial-fibrillation/comment-page-1/#comment-1750 Akul Fri, 01 Jul 2011 19:56:25 +0000 This is a good article on apixaban. However, to fully understand why oral factor Xa inhibitors are the hottest anticoagulants it would be a good idea to check out this <a href="http://pharmaxchange.info/press/2011/02/direct-factor-xa-inhibitors-as-anticoagulants/" rel="nofollow">Presentation on Direct Factor Xa Inhibitors as Anticoagulants</a> This is a good article on apixaban. However, to fully understand why oral factor Xa inhibitors are the hottest anticoagulants it would be a good idea to check out this Presentation on Direct Factor Xa Inhibitors as Anticoagulants

]]> Comment on Abnormal preprocedural international normalized ratio and platelet counts are not associated with increased bleeding complications after ultrasound-guided thoracentesis. by Robert Mahoney http://beckerinfo.net/JClub/2011/06/29/abnormal-preprocedural-international-normalized-ratio-and-platelet-counts-are-not-associated-with-increased-bleeding-complications-after-ultrasound-guided-thoracentesis/comment-page-1/#comment-1746 Robert Mahoney Wed, 29 Jun 2011 23:00:49 +0000 If you perform a thoracentesis (whether using ultrasound or not), do you have a cutoff for INR or platelet count? Does a study like this change your willingness to perform the procedure? If you perform a thoracentesis (whether using ultrasound or not), do you have a cutoff for INR or platelet count? Does a study like this change your willingness to perform the procedure?

]]> Comment on Antibiotics for gram-positive bacterial infection: vancomycin, teicoplanin, quinupristin/dalfopristin, oxazolidinones, daptomycin, telavancin, and ceftaroline. by Akul Mehta http://beckerinfo.net/JClub/2011/06/19/antibiotics-for-gram-positive-bacterial-infection-vancomycin-teicoplanin-quinupristindalfopristin-oxazolidinones-daptomycin-telavancin-and-ceftaroline/comment-page-1/#comment-1743 Akul Mehta Tue, 28 Jun 2011 02:06:11 +0000 This article talks about antibiotic resistance and mechanism of action. However to better understand the topic I would personally recommend the page on <a href="http://pharmaxchange.info/press/2011/02/animation-of-antimicrobial-resistance/" rel="nofollow">PharmaXChange.info for animations on antibiotic resistance</a>. This article talks about antibiotic resistance and mechanism of action. However to better understand the topic I would personally recommend the page on PharmaXChange.info for animations on antibiotic resistance.

]]> Comment on New synthetic antithrombotic agents for venous thromboembolism: pentasaccharides, direct thrombin inhibitors, direct Xa inhibitors. by Muhammed Abbas http://beckerinfo.net/JClub/2011/01/13/new-synthetic-antithrombotic-agents-for-venous-thromboembolism-pentasaccharides-direct-thrombin-inhibitors-direct-xa-inhibitors/comment-page-1/#comment-1675 Muhammed Abbas Thu, 05 May 2011 01:58:13 +0000 Excellent work done on factor Xa. Rivaroxicban for the Tx of VTA. Excellent work done on factor Xa. Rivaroxicban for the Tx of VTA.

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