vox médica : July 2015

Saturday, July 25, 2015

Medical Literary Messenger Spring 2015- Published Online.

The 2015 Spring Medical Literary Messenger is now published on line and accessible here.

The Medical Literary Messenger continues to grow by leaps and bounds. Both the number and quality of submissions exceeded our expectations. Enjoy the Spring 2015 edition of the MLM, may it touch you in unique ways and provide you new perspectives on humanism and medicine.

Gonzalo Bearman, MD
Editor in Chief

Thursday, July 23, 2015

Contact Precautions Revisited- Again!

In 2012, with my colleague Dr. Michael Stevens, we published a paper which no one read. The paper explored a change in the routine use of contact precautions for MRSA and VRE and may be accessed here.

We used our paper to support our argument for the discontinuation of contact precautions for the control of endemic MRSA and VRE at VCU Medical Center. The change was implemented and the strategy was a success. The results were published in Infection Control and Hospital Epidemiology.

More recently, along with collaborators from the Society for Healthcare Epidemiology of America (SHEA), we again explored the discontinuation of contact precautions for the control of MRSA and VRE in endemic settings, published here. We report that the majority (60%) of SHEA respondents were interested in using contact precautions differently. A handful of hospitals already do not isolate for MRSA and VRE. Not unexpectedly, in our thorough review of the literature, there is scant, quality evidence to support the use of contact precautions for the control of endemic MRSA and VRE.

Local needs and resources, not mandates, should drive the use of isolation precautions in healthcare settings.

This topic may now get more attention.

Stay tuned.

Tuesday, July 21, 2015

Statins and Effect on Pneumonia: True Effect or Bias?

Here is an elegant article published in Clinical Infectious Diseases.

Do statins truly have an anti-inflammatory effects that positively impact certain infectious diseases? In this case, the focus is on the use of statins, in patients status post a myocardial infarction (heart attack) and the protective impact on pneumonia. The protective effect of statins on pneumonia in these patients is based observational data where treatments were not assigned randomly. Using sophisticated staistical modeling, the protective effects of statins were assessed by excluding the effect of non-random assignment (bias) .

The finding? After controlling for non-randomization, the protective effect of statins against pneumonia was most likely the result of nonrandom treatment assignment, in other words, bias.

Be cautious of bias when interpreting study results, particularly with non-randomized,observational data.

Friday, July 17, 2015

Lyme Disease and Related IllnessesTwitter Chat- VCU Health Center

Today I was the guest expert on the the VCU Health Chat topic of Lyme disease.

The VCU News release can be accessed here.

The Twitter chat here.

Thank you to VCU News and to VCUHS Media Services for their assistance.

Thanks to the participants for their thoughtful questions.

Congratulations to Laura Pedersen and Matt Nottingham- VCU Medical Students at VCU MIDPH Research Day

Congratulations to Laura Pedersen and Matt Nottingham, our medical students in the VCU MIDPH program. Both presented their work today during the end of program research day.

Manuscripts are in progress. Stay tuned.

Kudos to both.

Laura Pedersen

Matt Nottingham

With Laura Pedersen, Matt Nottingham and Dr. Genet Peterson

Images from Chile and Argentina- July 2015

I took the last several weeks off from all things related to medicine while I was first in Chile for the Copa America final and then in my native Argentina. Here are some random images.

Now back to work and back to the grind.