Nursing Week’s Articles: 07/20/2009 – 07/29/2009
Ventilator Associated Pneumonia – an Overview
Wagh H et al. – Ventilator Associated Pneumonia (VAP) is pneumonia occurring in a patient within 48 hours or more after intubation with an endotracheal tube or tracheostomy tube and which was not present before. It is also the most common and fatal infection of ICU. VAP increases length of ICU stay by 28% and each incidence of VAP is estimated to generate an increased cost of £6000– £22000. Eliminating or reducing the unnecessary use of antibiotics should be the primary goal in reducing antibiotic–resistant nosocomial infections.
Glucose Control and Cardiovascular Disease in Type 2 Diabetes
Kelly TN et al. – This review of 5 large trials found that, compared with conventional control, intensive glucose control reduced the risk for some cardiovascular disease (such as nonfatal myocardial infarction), did not reduce the risk for cardiovascular death or all–cause mortality, and increased the risk for severe hypoglycemia. Health care providers should focus their efforts on combining elements of lifestyle modification, glucose control that minimizes hypoglycemia, blood pressure reduction, and lipid lowering to optimally curtail the risk for CVD in patients with type 2 diabetes.
Effects of Pay for Performance on the Quality of Primary Care in England
Campbell SM et al. – Against a background of increases in the quality of care before the pay–for–performance scheme was introduced, the scheme accelerated improvements in quality for two of three chronic conditions in the short term. However, once targets were reached, the improvement in the quality of care for patients with these conditions slowed, and the quality of care declined for two conditions that had not been linked to incentives. Continuity of care was reduced after the introduction of the scheme.
A combined role of calcium channel blockers and angiotensin receptor blockers in stroke prevention
Wang JG – Dihydropyridine calcium channel blockers, such as amlodipine, and angiotensin receptor blockers, such as valsartan, represent the two antihypertensive drug classes with the strongest supportive data for the prevention of stroke. Therefore, when combination therapy is required, a combination of these two antihypertensive classes represents a logical approach.
Ziprasidone vs clozapine in schizophrenia patients refractory to multiple antipsychotic treatments: The MOZART study
Sacchetti E et al. – This trial indicates that both ziprasidone and clozapine, having comparable efficacy coupled with satisfactory general safety and tolerability, may be regarded as valuable options for the short–term treatment of difficult–to–treat schizophrenia patients with a history of multiple resistance and/or intolerance to antipsychotics. The more favorable metabolic profile of ziprasidone may represent an added value that could guide clinicians, at least in the presence of patients at high risk for metabolic disorders.
Sego S – A vinegar cocktail each morning may not sound appealing, but growing evidence indicates it has impressive qualities and might make a big difference in the current obesity and diabetes epidemics. Although not appropriate for every patient, the idea certainly bears consideration.
Ziprasidone vs clozapine in schizophrenia patients refractory to multiple antipsychotic treatments: The MOZART study
Schizophrenia Research, 07/21/09
Sacchetti E et al. – This trial indicates that both ziprasidone and clozapine, having comparable efficacy coupled with satisfactory general safety and tolerability, may be regarded as valuable options for the short–term treatment of difficult–to–treat schizophrenia patients with a history of multiple resistance and/or intolerance to antipsychotics. The more favorable metabolic profile of ziprasidone may represent an added value that could guide clinicians, at least in the presence of patients at high risk for metabolic disorders.
