2010 Oct 6 - Chest Compression–Only CPR by Lay Rescuers and Survival From Out-of-Hospital Cardiac Arrest

Bentley J. Bobrow, MD; Daniel W. Spaite, MD; Robert A. Berg, MD; Uwe Stolz, PhD, MPH; Arthur B. Sanders, MD; Karl B. Kern, MD; Tyler F. Vadeboncoeur, MD; Lani L. Clark, BS; John V. Gallagher, MD; J. Stephan Stapczynski, MD; Frank LoVecchio, DO; Terry J. Mullins, MBA; Will O. Humble, MPH; Gordon A. Ewy, MD. JAMA. 2010;304(13):1447-1454.
Context Chest compression–only bystander cardiopulmonary resuscitation (CPR) may be as effective as conventional CPR with rescue breathing for out-of-hospital cardiac arrest.

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2010 Sep 22/29 - Rethinking Rapid Response Teams

Eugene Litvak, PhD; Peter J. Pronovost, MD, PhD. JAMA. 2010;304(12):1375-1376.
Current debate in the medical community centers on the benefits of rapid response teams (RRTs), hospital-based teams composed of clinicians with intensive care unit (ICU)–level clinical expertise. These teams rapidly respond when the condition of patients being cared for outside of the ICU suddenly deteriorates, and such patients often require transfer to ICUs.1

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2010 Sep 8 - Clinical Characteristics and 30-Day Outcomes for Influenza A 2009 (H1N1), 2008-2009 (H1N1), and 2007-2008 (H3N2) Infections

Edward A. Belongia, MD; Stephanie A. Irving, MHS; Stephen C. Waring, DVM, PhD; Laura A. Coleman, PhD; Jennifer K. Meece, PhD; Mary Vandermause, BSMT; Stephen Lindstrom, PhD; Debra Kempf, BSN; David K. Shay, MD, MPH. JAMA. 2010;304(10):1091-1098. doi:10.1001/jama.2010.1277
Context The clinical characteristics of pandemic 2009 influenza A(H1N1) infections have not been compared directly with illnesses caused by other influenza A strains.

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2010 Aug 25 - Elective Intra-aortic Balloon Counterpulsation During High-Risk Percutaneous Coronary Intervention: A Randomized Controlled Trial

Divaka Perera, MD, MRCP; Rodney Stables, DM, FRCP; Martyn Thomas, MD, FRCP; Jean Booth, MSc; Michael Pitt, MD, FRCP; Daniel Blackman, MD, MRCP; Adam de Belder, MD, FRCP; Simon Redwood, MD, FRCP; for the BCIS-1 Investigators. JAMA. 2010;304(8):867-874. doi:10.1001/jama.2010.1190

Figure. IABP tracing (Photo courtesy: ICU, PYNEH, Hong Kong)
Context Observational studies have previously reported that elective intra-aortic balloon pump (IABP) insertion may improve outcomes following high-risk percutaneous coronary intervention (PCI). To date, this assertion has not been tested in a randomized trial.

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2010 Aug - Surgical Decompression for Abdominal Compartment Syndrome in Severe Acute Pancreatitis

Panu Mentula, MD, PhD; Piia Hienonen, MD; Esko Kemppainen, MD, PhD; Pauli Puolakkainen, MD, PhD; Ari Leppäniemi, MD, PhD. Arch Surg. 2010;145(8):764-769.
Hypothesis In patients with severe acute pancreatitis and abdominal compartment syndrome, establishment of the indications and optimal time for surgical decompression may avoid exacerbation of multiple-organ dysfunction syndrome.

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2010 Aug 18 - System Delay and Mortality Among Patients With STEMI Treated With Primary Percutaneous Coronary Intervention

Christian Juhl Terkelsen, MD, PhD; Jacob Thorsted Sørensen, MD; Michael Maeng, MD, PhD; Lisette Okkels Jensen, MD, DmSc; Hans-Henrik Tilsted, MD; Sven Trautner, MD; Werner Vach, PhD; Søren Paaske Johnsen, MD, PhD; Leif Thuesen, MD, DmSc; Jens Flensted Lassen, MD, PhD. JAMA. 2010;304(7):763-771.
Context Timely reperfusion therapy is recommended for patients with ST-segment elevation myocardial infarction (STEMI), and door-to-balloon delay has been proposed as a performance measure in triaging patients for primary percutaneous coronary intervention (PCI). However, focusing on the time from first contact with the health care system to the initiation of reperfusion therapy (system delay) may be more relevant, because it constitutes the total time to reperfusion modifiable by the health care system. No previous studies have focused on the association between system delay and outcome in patients with STEMI treated with primary PCI.

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2010 Aug 18 - Prediction of Critical Illness During Out-of-Hospital Emergency Care

Christopher W. Seymour, MD, MSc; Jeremy M. Kahn, MD, MSc; Colin R. Cooke, MD, MSc; Timothy R. Watkins, MD; Susan R. Heckbert, MD, PhD; Thomas D. Rea, MD, MPH. JAMA. 2010;304(7):747-754.
Context Early identification of nontrauma patients in need of critical care services in the emergency setting may improve triage decisions and facilitate regionalization of critical care.

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2010 Aug 9 - Simplification of the Pulmonary Embolism Severity Index for Prognostication in Patients With Acute Symptomatic Pulmonary Embolism

David Jiménez, MD, PhD; Drahomir Aujesky, MD; Lisa Moores, MD; Vicente Gómez, MD; José Luis Lobo, MD, PhD; Fernando Uresandi, MD, PhD; Remedios Otero, MD, PhD; Manuel Monreal, MD, PhD; Alfonso Muriel, MSc; Roger D. Yusen, MD; for the RIETE Investigators. Arch Intern Med. 2010;170(15):1383-1389.
Background The Pulmonary Embolism Severity Index (PESI) estimates the risk of 30-day mortality in patients with acute pulmonary embolism (PE). We constructed a simplified version of the PESI.

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2010 Aug - Management of Thrombolysis-Associated Symptomatic Intracerebral Hemorrhage

Joshua N. Goldstein, MD, PhD; Marisela Marrero, MD; Shihab Masrur, MD; Muhammad Pervez, MD; Alex M. Barrocas, MD; Abdul Abdullah, MD; Alexandra Oleinik, BS; Jonathan Rosand, MD, MS; Eric E. Smith, MD, MPH; Walter H. Dzik, MD; Lee H. Schwamm, MD. Arch Neurol. 2010;67(8):965-969. doi:10.1001/archneurol.2010.175
Background Symptomatic intracerebral hemorrhage (sICH) is the most devastating complication of thrombolytic therapy for acute stroke. It is not clear whether patients with sICH continue to bleed after diagnosis, nor has the most appropriate treatment been determined.

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2010 Aug - JAMA Editorial: Decline in Invasive MRSA Infection: Where to Go From Here?

Eli N. Perencevich, MD, MS; Daniel J. Diekema, MD. JAMA. 2010;304(6):687-689. doi:10.1001/jama.2010.1125
Staphylococcus aureus, unlike many virulent pathogens, is a common commensal asymptomatically colonizing the nares1 and other body sites in approximately 30% of healthy individuals.

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2010 Aug 11 - Health Care–Associated Invasive MRSA Infections, 2005-2008

Alexander J. Kallen, MD, MPH; Yi Mu, PhD; Sandra Bulens, MPH; Arthur Reingold, MD; Susan Petit, MPH; Ken Gershman, MD, MPH; Susan M. Ray, MD; Lee H. Harrison, MD; Ruth Lynfield, MD; Ghinwa Dumyati, MD; John M. Townes, MD; William Schaffner, MD; Priti R. Patel, MD, MPH; Scott K. Fridkin, MD; for the Active Bacterial Core surveillance (ABCs) MRSA Investigators of the Emerging Infections Program. JAMA. 2010;304(6):641-647. doi:10.1001/jama.2010.1115
Context Methicillin-resistant Staphylococcus aureus (MRSA) is a pathogen of public health importance; MRSA prevention programs that may affect MRSA transmission and infection are increasingly common in health care settings. Whether there have been changes in MRSA infection incidence as these programs become established is unknown; however, recent data have shown that rates of MRSA bloodstream infections (BSIs) in intensive care units are decreasing.

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2010 Jun 23 - Infection Rate and Acute Organ Dysfunction Risk as Explanations for Racial Differences in Severe Sepsis

Florian B. Mayr, MD, MPH; Sachin Yende, MD, MS; Walter T. Linde-Zwirble; Octavia M. Peck-Palmer, PhD; Amber E. Barnato, MD, MS, MPH; Lisa A. Weissfeld, PhD; Derek C. Angus, MD, MPH, FRCP. JAMA. 2010;303(24):2495-2503.
Context Severe sepsis, defined as infection complicated by acute organ dysfunction, occurs more frequently and leads to more deaths in black than in white individuals. The optimal approach to minimize these disparities is unclear.

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2010 Jun - Acute Hemorrhagic Leukoencephalitis and Hypoxic Brain Injury Associated With H1N1 Influenza

Jennifer E. Fugate, DO; Erek M. Lam, MD; Alejandro A. Rabinstein, MD; Eelco F. M. Wijdicks, MD, PhD. Arch Neurol. 2010;67(6):756-758.
Objective To describe the first adult with neurologic complications associated with H1N1 influenza virus infection.

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2010 Jun 16 - Association of Corticosteroid Dose and Route of Administration With Risk of Treatment Failure in Acute Exacerbation of Chronic Obstructive Pulmonary Disease

Peter K. Lindenauer, MD, MSc; Penelope S. Pekow, PhD; Maureen C. Lahti, MBBS, MPH; Yoojin Lee, MS; Evan M. Benjamin, MD; Michael B. Rothberg, MD, MPH. JAMA. 2010;303(23):2359-2367.
Context Systemic corticosteroids are beneficial for patients hospitalized with acute exacerbation of chronic obstructive pulmonary disease (COPD); however, their optimal dose and route of administration are uncertain.

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2010 Jun 9 - JAMA Editorial: Preserving the Effectiveness of Antibiotics

Robert P. Gaynes, MD. JAMA. 2010;303(22):2293-2294.
Antibiotics are extraordinary medicine and are often curative. In general, antibiotics are remarkably free of adverse effects, eradicating the microorganism and usually leaving the host unaffected. Because antibiotics are typically well tolerated and effective, they are often used when the diagnosis of a bacterial infection is unclear. The liberal use of antibiotics has contributed to antibiotic resistance—a problem that has become a crisis.

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2010 Jun 9 - Clinical Outbreak of Linezolid-Resistant Staphylococcus aureus in an Intensive Care Unit

Miguel Sánchez García, MD, PhD; María Ángeles De la Torre, MD; Gracia Morales, PhD; Beatriz Peláez, PhD; María José Tolón, MD; Sara Domingo, MD; Francisco Javier Candel, MD, PhD; Raquel Andrade, PhD; Ana Arribi, MD, PhD; Nicolás García, MD; Fernando Martínez Sagasti, MD, PhD; José Fereres, MD, PhD; Juan Picazo, MD, PhD. JAMA. 2010;303(22):2260-2264.
Context Linezolid resistance is extremely uncommon in Staphylococcus aureus.

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2010 Jun 9 - Long-term Acute Care Hospital Utilization After Critical Illness

Jeremy M. Kahn, MD, MSc; Nicole M. Benson, BS; Dina Appleby, MS; Shannon S. Carson, MD; Theodore J. Iwashyna, MD, PhD. JAMA. 2010;303(22):2253-2259.
Context Long-term acute care hospitals have emerged as a novel approach for the care of patients recovering from severe acute illness, but the extent and increases in their activity at the national level are unknown.

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2010 Jun 2 - JAMA Editorial: Titrating Oxygen During and After Cardiopulmonary Resuscitation

Patrick M. Kochanek, MD; Hülya Bayr, MD. JAMA. 2010;303(21):2190-2191.
Several investigations have rekindled important concern that administration of 100% oxygen during and early after resuscitation from experimental cardiopulmonary arrest might be deleterious to the brain.

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2010 Jun 2 - Association Between Timeliness of Reperfusion Therapy and Clinical Outcomes in ST-Elevation Myocardial Infarction

Laurie Lambert, PhD; Kevin Brown, MSc; Eli Segal, MD; James Brophy, MD, PhD; Josep Rodes-Cabau, MD; Peter Bogaty, MD. JAMA. 2010;303(21):2148-2155.
Context Guidelines emphasize the importance of rapid reperfusion of patients with ST-elevation myocardial infarction (STEMI) and specify a maximum delay of 30 minutes for fibrinolysis and 90 minutes for primary percutaneous coronary intervention (PPCI). However, randomized trials and selective registries are limited in their ability to assess the effect of timeliness of reperfusion on outcomes in real-world STEMI patients.

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2010 Jun 2 - Association Between Arterial Hyperoxia Following Resuscitation From Cardiac Arrest and In-Hospital Mortality

J. Hope Kilgannon, MD; Alan E. Jones, MD; Nathan I. Shapiro, MD, MPH; Mark G. Angelos, MD; Barry Milcarek, PhD; Krystal Hunter, MBA; Joseph E. Parrillo, MD; Stephen Trzeciak, MD, MPH; for the Emergency Medicine Shock Research Network (EMShockNet) Investigators. JAMA. 2010;303(21):2165-2171.
Context Laboratory investigations suggest that exposure to hyperoxia after resuscitation from cardiac arrest may worsen anoxic brain injury; however, clinical data are lacking.

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