Best of Hospital Medicine 2013 Part 1
This week: 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 new 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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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).
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).