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The spark of contrast in the kidney

Expert thinking about contrast and kidney injury has shifted again, focusing on a few specific patient factors.

Therapeutic anticoagulation improves outcomes in sickle cell ACS vs. prophylactic dose

In patients with sickle cell disease and acute chest syndrome (ACS), receiving therapeutic doses of anticoagulation led to lower opioid use and shorter mean time to resolution compared to prophylactic doses, with no increase in bleeding, a French trial found.

Stroke risk may be lower than expected in patients diagnosed with AF while admitted

Patients diagnosed with atrial fibrillation (AF) during hospitalization for a noncardiac medical diagnosis or noncardiac surgery had a one-year stroke risk of 1% to 1.2% without anticoagulation, a retrospective study of older Canadians found.

Elevated troponin level at sepsis diagnosis did not predict in-hospital mortality

Patients with an elevated troponin level at sepsis diagnosis had similar hospital and ICU mortality and length of stay as those with normal levels, but they were more likely to have kidney dysfunction and worse long-term mortality, a prospective cohort study from South Korea found.

Bacterial infection unlikely in almost a third who got extended-spectrum antibiotics in ED

Among the nearly 60% of patients who got extended-spectrum antibiotics in the ED for suspected sepsis and were later judged to have definitely or probably had a bacterial infection, 79.1% received antibiotics that appeared to have been overly broad in retrospect, a study of seven U.S. hospitals found.

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Take a quiz about the April 16 issue!

Every week, ACP Hospitalist posts a question about the previous week's issue. See how well you remember what you've read compared to other readers.

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Take action on anaphylaxis

Know how to identify the signs of anaphylaxis and what to do about them.

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Choices in C. diff care

An infectious diseases expert gave an overview of the latest drugs and diagnostics at Internal Medicine Meeting 2025.

Beta-lactams noninferior to fluoroquinolones, trim-sulfa for uncomplicated gram-negative bacteremia

Patients transitioned to beta-lactams after treatment for uncomplicated gram-negative bacteremia had similar mortality and treatment failure as those who got fluoroquinolones or trimethoprim-sulfamethoxazole, a meta-analysis of retrospective studies concluded.

Intervention reduced antibiotic overuse for skin and soft-tissue infections

An electronic health record prompt, along with education and feedback, reduced extended-spectrum antibiotic use by 28% in low-risk patients with skin and soft-tissue infections without increasing ICU transfers or length of stay, according to results of a multicenter clinical trial.

Poor communication involved in almost a quarter of patient safety incidents

Poor communication was the only identified cause of 13.2% of patient safety incidents in four studies and a contributory cause in 24.0% in 42 studies, according to a systematic review that found low-strength evidence on the subject.

Optimal medical therapy for HFrEF associated with lower 30-day readmissions

Prescribing for patients with heart failure and reduced ejection fraction (HFrEF) was suboptimal, with only 77.9% getting beta-blockers, 70.3% renin-angiotensin-aldosterone system inhibitors, 41% mineralocorticoid receptor antagonists, 27.7% sacubitril/valsartan, and 17% sodium-glucose cotransporter-2 inhibitors, according to a retrospective study of community hospitals.

Parenteral, enteral, and malnutrition in the hospital

Malnutrition may be everywhere, but feeding won't fix every patient. Experts offered their advice on nutritional interventions.

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Beefing up on BCNE

The lead author of a recent statement on blood-culture negative endocarditis (BCNE) shared his advice at Internal Medicine Meeting 2025.

Correction to ‘Choices in C. diff Care’

An article in the April 16 issue required correction.


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