The American journal of the medical sciences
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Infectious disease (ID) clinicians and multidisciplinary teams may have a beneficial impact on patient outcomes. This study was conducted to determine the impact of dedicated ID team rounding in an adult noncardiac intensive care unit (ICU) on antimicrobial costs, length of stay and mortality. ⋯ Institution of dedicated ID team rounding in the ICU leads to substantial decreases in antimicrobial costs, hospital length of stay and inpatient mortality among those patients seen by the team.
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Training young physicians to perform research is challenging on many levels. Thus, many internal medicine training programs, including both core and subspecialty programs, struggle with providing a rigorous and successful research experience for their trainees. Here, the authors report on the rationale, design, practical implementation and outcome of a new program that was developed at the University Gastroenterology Fellowship Training Program. ⋯ Additionally, the proportion of trainees remaining in academic medicine increased from 14% before implementation of the program to 51% after it began. Several elements were viewed to be critically important for the program including the following: communication of expectations and development of a robust program structure, dedicated protected time, a dedicated research curriculum, programmatic support, mentorship and oversight as well as accountability/tracking of accomplishments. The authors conclude that institutions able to adopt these or similar approaches will reap the many rewards of discovery research performed by trainees.
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Letter Case Reports
Pomalidomide-Induced Pulmonary Toxicity in Multiple Myeloma.
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Randomized Controlled Trial Multicenter Study
A multicenter, randomized, trial comparing urapidil and nitroglycerin in multifactor heart failure in the elderly.
Multifactor heart failure is a common life-threatening event in elderly patients and often complicated by concomitant hypertension and diabetes mellitus (DM). The aim of this study was to evaluate whether α1-blocker, urapidil, provides additional therapeutic benefits compared to nitroglycerin (NG) in treatment of multifactor heart failure complicated by hypertension and DM in elderly patients. ⋯ Urapidil demonstrated better efficacy than NG on lowering and stabilizing systolic BP, attenuating cardiac afterload and improving cardiac function. Both NG and urapidil significantly reduced FPG levels in multifactor heart failure patients with DM. Urapidil is a therapeutic option for the multifactor heart failure patients complicated with hypertension and DM.