Pulmonary Embolism presenting as Syncope : Scare mongering at best

PESIT INVESTIGATORS published in this week of NEJM, reported that 17.3% of patients had PE who were admitted with first syncope to the hospital. This study has been circulated in various newspapers (1, 2, 3) as if  physicians are missing the big deadly cause of fainting spells, which is plain scare mongering. Emergency room physicians are already overusing … Read more

New Nomogram to predict Surgical ICU readmission

Martin et el  from the University of Utah School of Medicine, Salt Lake City developed a new nomogram to predict Surgical ICU readmission. What they did Studied 3,109 SICU admissions, with 141 patients readmissions within 72 hours of discharge from ICU. Came up with following risk factors patient age respiratory rate (breaths per minute) history of … Read more

Journal club : Empiricus trial

Empirical Micafungin Treatment and Survival Without Invasive Fungal Infection in Adults With ICU-Acquired Sepsis, Candida Colonization, and Multiple Organ Failure The EMPIRICUS Randomized Clinical a multicenter, randomized, double-blind, and parallel-group study Background Few randomized trials compared antifungals (fluconazole and capsofungin) to placebo empirically in critically ill septic patients. They failed to provide any benefit, however, empirical antifungal therapy is recommended … Read more

Time to say good bye to routine stress ulcer prophylaxis in ICU

Accepting that the world is full of uncertainty and ambiguity does not and should not stop people from being pretty sure about a lot of things. Julian Baggini WHATS NEW Pantoprazole or Placebo for Stress Ulcer Prophylaxis (POP-UP Study) In this randomized Double-Blind Exploratory Study by Selvanderan et el 214 patients were randomized to pantoprazole … Read more