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NSTEMI can wait
A French randomised controlled trial of patients suffering non-ST elevation myocardial infarction treated by immediate (mean time 70 minutes) versus delayed (mean time 21 hours) percutaneous coronary intervention revealed interesting results. There was no difference in myocardial infarction rates, as defined by peak troponin level, death or urgent revascularisation at one month. Perhaps unsurprisingly, the delayed group did spend significantly more time in hospital (JAMA 2009; 302: 947-54).
MARKERS MAY DECREASE ANTIBIOTIC USE
Prescribing based on the level of procalcitonin measured in patients with lower respiratory tract infections reduced antibiotic use when compared to treatment according to usual guidelines. The algorithm which was used advised antibiotics for patients with high levels of procalcitonin. The Swiss researchers report that using the procalcitonin algorithm resulted in similar rates of adverse outcomes (including death), but had the advantage of limiting use of antibiotics. Biochemical markers may prove to be useful in limiting bacterial resistance in the future by improving prescribing practices (JAMA 2009; 302: 1059-66).
STILL APPLES, NOT PEARS, BEWARES!
Sophia was contemplating her navel and body shape when her attention …