Highlights from the literature
Aspirin prevents thromboembolism
Recurrence of venous thromboembolic disease after stopping oral anticoagulation is acknowledged to be relatively common. A study published in the New England Journal of Medicine (2012;366:1959–67) randomised patients to receive either aspirin or placebo after completing between 6 and 18 months of oral anticoagulation therapy. Those patients who received aspirin proved to have a significantly reduced rate of recurrent venous thromboembolism. There were no increased adverse bleeding events in the aspirin group noted.
Hospital at home
Do patients recover from exacerbations of chronic obstructive pulmonary disease better at home than in hospital? That is the question asked by a Cochrane review. The results from eight trials involving 870 patients were reviewed and analysed. A significant reduction in re-admission rates was noted in those patients who were managed at home with the help of respiratory nurses compared with those treated in hospital. Patients with acute confusion, electrocardiogram changes or x-ray changes were excluded from this approach. (Cochrane Database of Systematic Reviews 2012, Issue 5. Art. No.: CD003573).
Crisis resource management
Training for emergency physicians …