geoffrey modest medical blogs

A quasi-randomized trial of hydroxychloroquine in patients with COVID-associated pneumonia in  Detroit, Michigan  found worse outcomes with the med ( see  covid hydroxychloroquine RTC   nejm2020  in dropbox ).   This study was just submitted to the New England Journal of Medicine, as a  pre-publication and pre-peer reviewed submission Details: -- 63 consecutive adults with viral pneumonia, secondary to SARS-CoV-2 infection (documented by PCR) during a two-week period in March 2020 -- the trial was done in 2 different hospitals in Detroit, 7 miles apart, and serving the same general population -- 41% female (though 53% were on hydroxychloroquine/29% on standard care),  baseline  absolute   lymphocyte count 0.92 K/ m L , baseline  absolute   neutrophil count 5.7 K/ m L, baseline respiratory support requirement 1.7 (statistically significant difference of 1.94 on hydroxychloroquine vs 1.52 on standard care,...

home-based hospital level care works G  Like     Geoff A. Modest, M.D. Wed 1/8/2020 8:19 AM Geoff A. Modest, M.D.  A recent RCT found that hospital level care   delivered at home   for acutely ill adults  was not only less expensive but also reduced hospital readmissions, as compared to in-hospital care (s ee  home based   hosp   care AIM2019  in   dropbox , or doi:10.7326/M19-0600 ) Details: -- 91 adult patients presenting to the ED at either Brigham and Women’s Hospital (BWH, an academic medical center) or Brigham and Women’s Faulkner Hospital (a community hospital with medical residents from BWH), both in Boston -- median age 76, 36% female, 50% white/22% black/18% latinx, 37% partnered/15% divorced/30% single, 75% English speaker, 35% <high school education/14% high school, 25% employed, 55% never-smoker/14% current, 3...