Prothrombin Complex Concentrate vs Factor VII for Refractory Bleeding in Cardiac Surgery.

Background: Perioperative bleeding remains an important complication of cardiac surgery. Current guidelines support goal-directed use of coagulation factor concentrates in refractory bleeding, but the optimal strategy is unclear. Four-factor prothrombin complex concentrate (4F-PCC) has theoretical advantages over recombinant activated factor VII (rFVIIa) because of expanded mechanistic targets and lower rates of adverse events, but comparative data are limited.

Outbreak of nosocomial Burkholderia cepacia infection and colonization associated with intrinsically contaminated mouthwash.

From August 1996 through June 1998, 69 ventilated, intensive care unit patients at two Arizona hospitals had nosocomial respiratory tract cultures positive for Burkholderia cepacia. Intrinsically contaminated alcohol-free mouthwash was identified by pulsed-field gel electrophoresis as the source of the outbreak.

What is the marginal cost for marginal risk in cardiac surgery?

Background: It has been shown that postoperative length of stay (LOS) correlates highly with mortality risk for cardiac surgical procedures. Similar correlations have been found for charges with LOS and costs with risk.

Methods: Postoperative LOS and risk scores were obtained, tabulated, and compiled into the five original Parsonnet risk groups for 2,589 patients who underwent cardiac operations from 1992 through 1996 at one hospital.

Typhim Vitrade mark Vaccine.

Long before the term "Typhoid Mary" entered the vernacular in the early 1900s, investigators such as Huxham1 in 1782 and Schoenlein2 in 1839 had already differentiated typhoid fever-the typhus-like fever caused by Salmonella typhi-from other prolonged febrile syndromes such as rickettsial typhus fever.3 The notorious Mary Mallon had been identified as a carrier of the typhoid fever bacillus in 1907; by the time she was captured 8 years later, she had infected at least 50 people (causing the death of three) while working as a New York City cook under several assumed names.4 Even though the incidence of this serious infection has obviously decreased since 1900 in developed countries, it continues to be prevalent in developing countries.