ITL: Physician Reviews of HM-Relevant Research

The Hospitalist. 2012 July;2012(07):

July 3, 2012 | The Hospitalist

Sanjay Galhotra, MD ; Paul Martin, MD, MPH ; Martina Stehlikova, MD ; Claire Brown, MD ; Valentyna Goloborodko, MD ; Andrea Porovecchio, MD ; Jeff Ceresnak, MD ; William Southern, MD, MS, SFHM

Data were not sufficient for evaluation of prolonged prophylaxis for total knee replacement and hip fracture surgery.

Bottom line: Prolonged prophylaxis is associated with fewer VTE events in patients with hip replacement but also carries increased risk of minor bleeding.

Citation: Sobieraj DM, Lee S, Coleman CI, et al. Prolonged versus standard-duration venous thromboprophylaxis in major orthopedic surgery: a systematic review. Ann Intern Med. 2012 May 15 [Epub ahead of print].

Clinical Shorts

COLISTIN COULD BE A USEFUL ALTERNATIVE TO STANDARD ANTIBIOTICS FOR TREATMENT OF VENTILATOR-ASSOCIATED PNEUMONIA

This systematic review and meta-analysis of colistin versus standard antibiotics for ventilator-associated pneumonia found no significant differences in clinical response, mortality, or nephrotoxicity.

Citation: Florescu DF, Qiu F, McCartan MA, et al. What is the efficacy and safety of colistin for the treatment of ventilator-associated pneumonia? A systematic review and meta-regression. Clin Infect Dis. 2012;54:670-680.

FECAL TRANSPLANTATION REALLY DOES WORK FOR REFRACTORY CLOSTRIDIUM DIFFICILE INFECTION

In this retrospective analysis from Finland of 70 patients with recurrent Clostridium difficile infection who underwent fecal transplantation, symptoms resolved in 89% of

patients with the 027 strain and in all patients without this strain.

Citation: Mattila E, Uusitalo-Seppälä R, Wuorela M, et al. Fecal transplantation, through colonoscopy, is effective therapy for recurrent Clostridium difficile infection. Gastroenterology. 2012;142:490-496.

OBSTRUCTIVE SLEEP APNEA IS ANOTHER RISK FACTOR FOR DEEP VEIN THROMBOSIS

This pair-matched cohort study from Taiwan suggests a threefold increased risk of deep vein thrombosis in patients with sleep apnea independent of age and comorbidities.

Citation: Chou KT, Huang CC, Chen YM, et al. Sleep apnea and risk of deep vein thrombosis: a non-randomized, pair-matched cohort study. Am J Med. 2012;125:374-380.

ORAL XA INHIBITORS BETTER THAN ENOXAPARIN FOR VTE PROPHYLAXIS AFTER HIP OR KNEE REPLACEMENT

This meta-analysis of 22 trials showed that, when compared with enoxaparin, low doses of oral direct Factor Xa inhibitors moderately reduced the incidence of symptomatic DVT but had no effect on incidence of pulmonary embolism or mortality.

Citation: Neumann I, Rada G, Claro JC, et al. Oral direct Factor Xa inhibitors versus low-molecular-weight heparin to prevent venous thromboembolism in patients undergoing total hip or knee replacement: a systematic review and meta-analysis. Ann Intern Med. 2012 May 15 [Epub ahead of print].