Best of Hospital Medicine 2013 Part I


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Originally Aired September 24, 2014: Fecal Transplantation & Probiotics for C. difficile; Prone Positioning in ARDS; Steroids in COPD; Hospital Management of Diabetes.

Fahad and Amol want you to gain familiarity with a number of major studies in hospital medicine published in 2013.

1. Fecal transplantation is effective for recurrent C. difficile infection.

2. Probiotics are not effective in preventing C. difficile.

3. Prone positioning can reduce mortality in patients with moderate-to-severe ARDS.

4. A 5-day course of steroids was as effective as a 14-day course in patients with COPD exacerbations.

5. A simplified basal insulin + sliding scale insulin regimen was as effective as basal-bolus insulin in managing mild-to-moderate diabetes in hospital.

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The papers

AJ Calderon et al. Update in hospital medicine: evidence published in 2013. Ann Internal Med 2014 Jul 15 161(2) 139-144. (PubMed)

E V Nood et al. Duodenal Infusion of Donor Feces for Recurrent Clostridium difficile. N Engl J Med 2013 Jan 31;368(5):407-15. (PubMed).

S J Allen et al. Lactobacilli and bifidobacteria in the prevention of antibiotic-associated diarrhoea and Clostridium difficile diarrhoea in older inpatients (PLACIDE): a randomised, double-blind, placebo-controlled, multicentre trial. Lancet 2013 Oct 12;382(9900):1249-57. (PubMed).

C Guérin et al. Prone Positioning in Severe Acute Respiratory Distress Syndrome. N Engl J Med 2013 Jun 6;368(23):2159-68. (PubMed).

J D Leuppi et al. Short-term vs conventional glucocorticoid therapy in acute exacerbations of chronic obstructive pulmonary disease: the REDUCE randomized clinical trial. JAMA 2013 Jun 5;309(21):2223-31.(PubMed).

 G E Umpierrez et al. Randomized Study Comparing a Basal Bolus With a Basal Plus Correction Insulin Regimen for the Hospital Management of Medical and Surgical patients With Type 2 Diabetes. Diabetes Care 2013 Aug;36(8):2169-74. (PubMed).

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