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A study was conducted to evaluate and compare the outcomes of patients hospitalized with acute exacerbation of chronic obstructive pulmonary disease (COPD) treated with low doses of corticosteroids administered orally as against those treated with higher doses intravenously. Results indicated that orally administered steroids did not have worse outcomes as compared to intravenously administered ones.

A study was conducted to evaluate and compare the outcomes for patients hospitalized for acute exacerbations of chronic obstructive pulmonary disease (COPD) treated with antibiotics in the first 2 days of admission as against those treated later or not at all. Results indicated that early administration of antibiotics led to better and more improved outcomes in the case of such patients.

This study describes oral temperatures in a large sample of nonsurgical inpatients without infections to inform evaluation of fever in the hospital. [ABSTRACT FROM AUTHOR]

The article presents the results of a retrospective cohort study to identify outcomes of patients who presented with chest pain in a medical center in Massachusetts in 2007-2008. The review of cases of more than 2,000 patients revealed that patients underwent stress testing, with some of those who had abnormal results readmitted for other procedures due to major cardiovascular events. The article discusses the study's methodology, limitations, pertinent findings and conclusions.

The article discusses a study on the trends in hospital admissions and outcomes for patients with pneumonia, sepsis and respiratory failure including an evaluation of changes in hospitalization and mortality rates among patients. A temporal trends study was conducted using data from the 2003-2009 releases of the Nationwide Inpatient Sample (NIS) which was validated against the National Hospital Discharge Survey. It concludes that changing patterns in diagnostic coding offers a reason to doubt that improvements in the mortality of patients diagnosed with pneumonia accurately reflect trends in pneumonia outcomes.

The article discusses a study on variations in hospital costs and hospital mortality rates of patients with sepsis in the U.S. The study involved 309 hospitals in the Perspective database of Premier Healthcare Informatics in North Carolina from June 1, 2004 to June 30, 2006. Results showed minimal correlation between overall levels of spending and hospital survival. Also noted is the small percentage of patients discharged to hospice.

In this narrative medicine essay, a physician reflects on his father's experience, at the age of 85 years, of getting a physical examination from a new primary care physician that ended up setting off a cascade of examinations and treatments. [ABSTRACT FROM AUTHOR]

Several letters to the editor are presented in response to the article "Association of corticosteroid dose and route of administration with risk of treatment failure in acute exacerbation of chronic obstructive pulmonary disease," by P. K. Laindenauer and colleagues published in a 2010 issue of the "Journal of the American Medical Association."

Several letters to the editor are presented in response the article "Antibiotic Therapy and Treatment Failure in Patients Hospitalized for Acute Exacerbations of Chronic Obstructive Pulmonary Disease," by M. B. Rothberg and colleagues, published in previous issue, including a comment on the methods used in the study, a clarification on the impact of immortal time bias on chronic obstructive pulmonary disease (COPD) exacerbation, and a response from the authors.

The author explains the rationale of performing an annual physical examination on a healthy patients. Topics discussed include the cost of examining health patients, the Medicare coverage for annual wellness visits, and the need to reeducate patients about routine health checks. The dangers of overdiagnosis is also mentioned.

A letter to the editor is presented in response to the suggestions given on research activity in residency including devotion of more resident time, faculty focus and funding.

The author reflects on the Accreditation Council for Graduate Medical Education in the U.S. program which facilitates residents' doctors and physicians' participation in scholarly activities. He mentions that resident research will promote advancement in evidence based medicine, quality of patients care and develop critical thinking. Also investigated are several ways to avail research grants and appropriate time for conducting research by resident clinicians.

A letter to the editor in response to the study "Herpes Zoster Vaccine in Older Adults and the Risk of Subsequent Herpes Zoster Disease" by Doctor Hung Fu Tseng and colleagues published in a 2011 issue and a reply by Tseng and Steven J. Jacobsen to the letter are presented.