Urinary eosinophils have been associated with acute interstitial nephritis (AIN). The positive predictive value of the test has been estimated as 38%, the negative predictive value, 74% [1]. An excellent review article can be found online from the American Academy of Family Physicians [2].
The American College of Cardiology guidelines on post-myocardial infarction care suggest that "in stable patients without complications (class I), sexual activity with the usual partner can be resumed within 1 week to 10 days" [1]
Brown County Hospital, a public hospital in Georgetown Ohio east of Cincinnati, is managed by Quorum. Quorum and another company, Triad, sprang from HCA. All three are hospital management companies [1, 2].
Case reports describe communities whose once public hospitals, now Quorum or Triad managed, are devalued, closed or replaced by new for-profit facilities. The end result can be less public management and less public care [3]. (This downloads a 10-page pdf file)
Economic theory, social responsibility
Are corporations bound by social responsibility? Adam Smith distinguishes self interest from greed.
"Every individual necessarily labours to render the annual revenue of the society as great as he can. He generally, indeed, neither intends to promote the public interest, nor knows how much he is promoting it...he intends only his own gain, and he is in this, as in many other cases, led by an invisible hand to promote an end which was no part of his intention. Nor is it always the worse for the society that it was no part of it. By pursuing his own interest he frequently promotes that of the society more effectually than when he really intends to promote it. I have never known much good done by those who affected to trade for the public good.
It is not from the benevolence of the butcher, the brewer, or the baker, that we expect our dinner, but from their regard to their own interest. We address ourselves, not to their humanity but to their self-love, and never talk to them of our own necessities but of their advantages."
This comes from an article in the Economist entitled "The Good Company."
The article is available online only with a subscription[4]. But Adam Smith's writings are free, full-text online [5].
The Economist article continues...
"Smith did not worship selfishness. He regarded benevolence as admirable, as a great virtue, and he saw the instinct for sympathy towards one's fellow man as the foundation on which civilised conduct is built (he wrote another book about this: “The Theory of Moral Sentiments”). But his greatest economic insight—and indeed the greatest single insight yielded by the discipline of economics—was that benevolence was not in fact necessary to advance the public interest, so long as people were free to engage with each other in voluntary economic interaction. That is fortunate, he pointed out, since benevolence is often in short supply. Self-interest, on the other hand, is not."
The Economist concludes in a large way...
"If self-interest, guided as though by an invisible hand, inadvertently serves the public good, then it is easy to see why society can prosper even if people are not always driven by benevolence. It is because Smith was right about self-interest and the public interest that communism failed and capitalism worked."
Hypoglycemia associated with fluoroquinolones can be profound--including ciprofloxacin [1, 2, 3, 4, 5, 6].
Discussion came up about quinolones and tendon pathology, including rupture. Animal studies have shown cystic degneration of tendons after quinolone exposure.
Here is a general review of quinolones [1], and a series of papers on associated tendonopathy [2, 3, 4, 5, 6]
(Are other antibiotics associated with tendonopathy? I do not know. The literature clusters around quinolones.)
A man without diabetes has cellulitis of a leg and mild CHF. He is afebrile with a normal white blood cell count. Cefazolin is ordered. Should we add clindamycin?
In a NEJM review of cellulitis from February of 2004, Dr. Morton Swartz still favors cefazolin as initial therapy in non-toxic patients without diabetes [1]. (Citation links to an abstract, but fulltext is available with free registration.) In letters to the editor physicians who see a lot of community-acquired MRSA suggest clindamycin [2].
Should blood cultures be sent for cellulitis? Unless the patient is toxic, no. Positive culture rates have been reported to be around 2% [3].