June 17th, 2013

Selections from Richard Lehman’s Literature Review: June 17th

CardioExchange is pleased to reprint selections from Dr. Richard Lehman’s weekly journal review blog at BMJ.com. Selected summaries are relevant to our audience, but we encourage members to engage with the entire blog.

BMJ  15 June 2013  Vol 346

Associations Between the Organization of Stroke Services, Process of Care, and Mortality in England: Stroke care improvement programmes in the UK seem to work, just as stroke centres did when they were first set up. A prospective cohort study examines the figures and looks for the contribution made by each element of improved care. Once again we get this wretched word bundle, and Bundle 4 is defined as: “patient given antiplatelet therapy where appropriate and had adequate fluid and nutrition for first 72 hours.” Why on earth bundle together adequate food and fluid with antiplatelet therapy? Anyway, this bundle makes the most difference: it is perhaps a marker for units where the nurses have enough time to make sure the patients are fed and watered.

JAMA Intern Med  10 June 2013 Vol 173

Waste and Harm in the Treatment of Mild Hypertension (pg. 956):  It’s great to see Iona Heath featured in a viewpoint on waste and harm in the treatment of mild hypertension in a leading US journal. It is taking so long for the entrenched models of thinking about cardiovascular risk factors to give way to a patient centred view of risk and benefit.


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