Graying of the HIV epidemic: a challenge for inpatient medicine providers.

Since the advent of anti-retroviral therapy, patients with HIV are living longer, and in the year 2015, over half of those infected with the virus will be older than age 50. Moreover, as the general aging population continues to grow, more elderly individuals will become newly infected with HIV. Older patients with HIV contribute to high numbers of initial and rehospitalizations, have longer lengths of hospital day stays, and are at increased risk of death compared to younger patients with HIV and those without HIV.

Impact of antibiotic choices made in the emergency department on appropriateness of antibiotic treatment of urinary tract infections in hospitalized patients.

Background: Overuse of antibiotics to treat urinary tract infections (UTIs) is common in hospitalized patients and may begin in the emergency department (ED).

Methods: For a 4-week period we reviewed medical records of all patients admitted to the hospital who initiated treatment for a UTI in the ED.

Results: According to study criteria, initiation of antibiotics was inappropriate for 55 of 94 patients (59% [95% confidence interval {CI}, 48%-69%]), and continuation after admission was inappropriate for 54 of 80 patients (68% [95% CI, 57%-78%]).

PCR offers no advantage over culture for microbiologic diagnosis in cellulitis.

Purpose: Most cases of cellulitis are traditionally attributed to β-hemolytic Streptococcus and Staphylococcus species, although in most cases, no organism is identified. Development of PCR using the conserved bacterial 16 S rRNA DNA permits identification of bacteria independent of conventional culture approaches and prior use of antibiotics.

Methods: We used PCR-based techniques to identify cellulitis etiology using aspirate samples from affected skin.

The effect of computerized provider order entry on medical students' ability to write orders.

Background: Computerized provider order entry (CPOE) is being implemented at increasing numbers of U.S. hospitals, yet the effects of CPOE on medical student education are largely unstudied.

Improving utilization of antimicrobial drugs among physician assistants in the ED.

Objective: This study examines the effectiveness of an educational intervention that used audit and feedback to influence physician assistant (PA) antimicrobial utilization in an emergency department (ED).

Methods: Twelve ED PAs participated in this pre- and postintervention study. Their prescribing patterns were retrospectively reviewed and classified as appropriate, effective but inappropriate, or inappropriate using a previously developed methodology.

The good news about CPOE and medical student ordering ability.

When the quality of orders written by medical students was compared for those who trained at hospitals using computerized provider order entry (CPOE) to those who trained using handwritten orders, no significant differences were found.

Phasic inhibition of dopamine uptake in nucleus accumbens induced by intravenous cocaine in freely behaving rats.

A new approach combining fast-scan cyclic voltammetry with iontophoretic dopamine delivery was used in freely behaving rats to evaluate the time-course of dopamine uptake inhibition in nucleus accumbens induced by intravenous cocaine at a dose (1.0mg/kg) known to maintain self-administration behavior. Cocaine significantly increased the decay time of the dopamine response without altering its magnitude or time to peak.