August 15, 1997, Tip Sheet

Annals of Internal Medicine is published by the American College of Physicians (ACP), more than 100,000 physicians trained in internal medicine. The following highlights are not intended to substitute for articles as sources of information. For a copy of an article, call 1-800-523-1546, ext. 2656 or 215-351-2656. The full text of selected articles can be accessed on the Internet at http://www.acponline.org/journals/annals/annaltoc.htm

* * * New Strategies for Preventing Catheter-Related Infections

Two new studies show that antiseptic or antimicrobial-coated catheters substantially reduce the risk of catheter-related bacterial colonization and blood stream infections which are an important complication of hospitalization. A randomized, controlled clinical study found that antiseptic-coated catheters are well-tolerated, reduce the incidence of catheter-related infection, extend the time that central venous catheters can be safely left in place for the short term, and may be cost-saving. (Article, p. 257.)

The second study, a multicenter, randomized clinical trial, showed that catheters coated with the antimicrobial agents minocycline and rifampin decreased the risk for bloodstream infection and were not associated with adverse effects or with antimicrobial resistance. (Article, p. 267.)

An accompanying editorial discusses the implications of using catheters coated with antimicrobial or antibacterial agents to reduce the incidence of infection among critically ill patients, and in settings where rates of catheter-related infection remain high despite adherence to infection control measures. (Editorial, p. 294.)

* * * Moral Lessons Learned From Nazi Physicians

An editorial revisits the moral lessons learned from Nazi doctors convicted at the Nuremberg trials for their involvement in medical experiments at Auschwitz. (Editorial, p. 307.)

* * * Guidelines for Assessing and Managing the Perioperative Risk From Coronary Artery Disease

New guidelines from the American College of Physicians address managing and assessing a patient's risk for major cardiac events during or after a noncardiac operation. (Position Paper, p. 309.)

An accompanying background paper summarizes the available evidence on cardiac risk stratification before noncardiac surgery. (Position Paper, p. 313.)

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