动脉瘤性蛛网膜下腔出血脑血管痉挛患者心电图及运动诱发电位检测的临床意义

目的：探讨动脉瘤性蛛网膜下腔出血（aSAH）患者心电图检测对脑血管痉挛（CVS）的预测作用。方法：选择2010年1月~2014年12月来我院接受治疗的aSAH患者120例。根据患者有无并发CVS分为并发CVS组（n=40）和未并发CVS组（n=80）,临床医生应根据病历信息及临床检查详细记录aSAH患者的临床指标及白细胞计数、血钙、血钠、血小板计数、血红蛋白浓度、MMP-9、Hunt-Hess分级、Fisher分级等指标,并对aSAH患者行心电图及MEP检测。应用单因素、多因素非条件Cox回归分析进行aSAH患者并发CVS的危险因素分析。结果：120例aSAH患者临床特征显示,两组在吸烟史、Hunt-Hess分级≥III级、Fisher分级≥III级、白细胞数量、血红蛋白浓度、QT间期延长、ST段抬高、MMP-9水平、CCT延长、SP延长方面差异显著（P＜0.05）。其中,aSAH患者并发CVS组QT间期延长、ST段抬高、CCT延长、SP延长患者比例患者比例显著高于未并发CVS组（P＜0.05）。Cox回归分析结果显示,Hunt-Hess分级≥III级、Fisher分级≥III级、QT间期延长、ST段抬高、CCT延长、SP延长会增加aSAH患者并发CVS的风险（P＜0.05）。结论：临床医师在诊治aSAH患者过程中,应格外注意患者心电图及MEP检测指标。     

术中脑池内冲洗尼莫地平治疗蛛网膜下腔出血后脑血管痉挛37例

正脑血管痉挛(CVS)是动脉瘤性蛛网膜下腔出血(aSAH)患者严重并发症之一,常导致神经功能进一步恶化。aSAH患者约有70%以上可出现不同程度CVS。尼莫地平对于预防和治疗aSAH患者CVS的作用已得到公认,但由于考虑存在颅内感染及粘连等拔管时损伤重要结构的因     

3H疗法治疗脑血管痉挛是否有效

脑血管痉挛（cerebral vasospasm，CVS）是指正常脑动脉在某些病理因素刺激下，发生可逆性收缩，导致供血区脑组织灌注下降，脑组织缺血、缺氧的临床现象。动脉瘤性蛛网膜下腔出血（aneurysmal subarachnoid hemorrhage，aSAH）后，经血管造影证实，高达70％的患者有CVS，并造成约36％的患者脑缺血或脑梗死。尽管给予患者最强力的治疗，仍有15％～20％的CVS患者出现脑梗死或者死亡。CVS成为aSAH患者最常见和最严重的并发症。     

心电图异常与动脉瘤性蛛网膜下腔出血后脑血管痉挛的关系

目的:探讨心电图异常与动脉瘤性蛛网膜下腔出血(aSAH)后脑血管痉挛(CVS)的关系。方法:收集2002年2月~2015年2月在我院神经内科住院的709例aSAH患者为研究对象,根据是否发生CVS分为非CVS对照组(499例)和CVS组(210例)。所有研究对象接受心电图检查,采用单因素及多因素Logistic回归分析心动过缓、心动过速、QT间期延长、ST段抬高、ST段降低、T波倒置、出现u波等心电图异常因素与aSAH后CVS的关系。结果:单因素分析结果提示:心动过缓、QT间期延长、ST段抬高、ST段降低、T波倒置、出现u波是aSAH后CVS的危险因素(P0.05或0.01)。多因素Logistic回归分析显示QT间期延长是aSAH后CVS的独立危险因素(OR=13.502,P=0.001)。结论:对于存在脑血管痉挛高危因素(心电图异常)的动脉瘤性蛛网膜下腔出血患者,应加强监测,以降低或避免脑血管痉挛发生,改善其预后。     

血管内治疗动脉瘤性蛛网膜下腔出血后脑血管痉挛的研究进展

脑血管痉挛(cerebral vasospasm,CVS)所致的迟发性脑缺血(delayed cerebral ischemia,DCI)是动脉瘤性蛛网膜下腔出血(aSAH)患者死亡或残疾的主要原因之一[1]。目前防治aSAH后CVS的主要措施包括口服尼莫地平、3-H疗法(高血压、高血容量、血液稀释治疗)、经静脉使用血管舒张剂,血管内治     

磁共振灌注加权成像对蛛网膜下腔出血后脑血管痉挛患者脑血流动力学的评估

目的观察动脉瘤性蛛网膜下腔出血（aSAH）后,磁共振灌注成像（PWI）显爪脑血流参数的变化,探讨脑血流动力学与脑血管痉挛间的父系。方法选择aSAH≤7d的患者38例,另选同期无SAH的颅内动脉瘤患者10例作为对照组。行全脑DSA检查,观察患者腑m管痉挛（CVS）程度;行PWI检查,采集大腑前动脉（ACA）、大腑中动脉（MCA）供血区及基底核区（BSGL）的相应感必趣区的相对脑血流量（rCBF）、相对脑血容量（rCBV）、平均通过时间（MTF）和达峰时间（TTP）参数。分析这些参数与CVS的相关性。结果①DSA检查屁示,38例中,28例至少有1支血管痉挛,其中轻度痉挛有9例,中度痉挛有10例,重度痉挛有9例;10例未发现CVS。②与对照组比较,重度痉挛组ACA、MCA、BSGL供血区rCBF、rCBV均降低,且差异有统计学意义（P〈0．05～0．01）;而无痉挛组、轻度痉挛组、中度痉挛组、币度痉挛组各血管供血区的rCBF、rCBV均有降低趋势,但降低的程度不同。与对照组比较,轻度痉挛组、巾度痉挛组、重度痉挛组ACA、MCA、BSGL供血区的MTT、TTP均有延长趋势,CVS越重,延长就越明显,其中,中、重度痉挛组差异有统计学意义（P〈0．05～0．01）。@Spearman等级相关分析显示,CVS程度与各供血区的rCBF及rCBV呈负相关,rs均〈0．4,为低度相关;与MTT、TTP呈正相关,rs．0．310～0．730,为中度相关。结论PWI检查可以定量地提供脑组织血流灌注的信息。PWI检查所采集的各供血区rCBF、rCBV、MTT、TTP4个参数中,MTT和TTP参数与CVS程度的符合性更好。     

尼莫地平与依达拉奉联合应用对动脉瘤性蛛网膜下腔出血后脑血管痉挛和迟发性脑缺血的影响

目的 探讨尼莫地平与依达拉奉联合应用对动脉瘤性蛛网膜下腔出血(aneurysmal subarachnoid hemorrhage,aSAH)后脑血管痉挛(cerebral vasospasm,cVS)和迟发性脑缺血(delayed cerebral ischemia,DCI)的影响.方法 回顾性纳入连续接受手术夹闭的aSAH患者.所有患者术后持续微量泵入尼莫地平,部分患者加用依达拉奉(30 mg,2次/d,连用2周).根据经颅多普勒检查结果分为CVS组和非CVS组,根据CT复查和临床检查结果分为DCI组和非DCI组.收集人口统计学、基线临床资料、格拉斯哥昏迷量表(Glasgow Coma Scab,GCS)评分、Fisher分级、Hunt-Hess分级和动脉瘤部位.应用多变量logistics回归分析确定CVS和DCI的独立危险因素.结果 共纳入220例aSAH患者,132例(60.0％)发生CVS;106例(48.2％)发生DCI;123例(55.9％)接受尼莫地平+依达拉奉治疗,97例(44.1％)仅接受尼莫地平治疗;无死亡病例.接受尼莫地平+依达拉奉治疗的患者CVS(51.2％对71.1％;x2=8.962,P=0.003)和DCI(35.0％对65.0％;∥=19.535,P＜0.001)发生率均显著低于仅接受尼莫地平治疗的患者.CVS组高血压、高脂血症、糖尿病、吸烟、高风her分级的比例显著高于非CVS组(P均＜0.05),而接受尼莫地平+依达拉奉治疗的患者比例(47.7％对68.2％x2=8.962,P=0.003)和GCS评分[(11.2±3.1)分对(13.4±2.6)分;=5.492,P ＜0.001]显著低于非CVS组.多变量logistic回归分析显示,低GCS评分[优势比(odds ratio,OR)6.57,95％可信区间(confidence interval,凹)1.04～12.96;P＜0.001]、高Fisher分级(OR 5.39,95％ CI4.09 ～20.15;P＜0.001)、高脂血症(OR 4.39,95％ CI2.97～34.15;P=0.004)、高血压(OR 3.24,95％ CI 1.06 ～ 13.47;P =0.016)是CVS的独立危险因素,而接受尼莫地平+依达拉奉治疗是CVS的独立保护因素(OR0.39,95％ CI0.13 ～0.91;P=0.039).DCI组高血压、高脂血症、糖尿病、吸烟和高Fisher分级的患者比例显著高于非DCI组(P均＜0.05),而接受尼莫地平+依达拉奉治疗的患者比例(40.6％对70.2％;∥=19.535,P＜ 0.001)和GCS评分[(10.2±2.4)分对(13.8±2.6)分;净10.648,P＜0.001]显著低于非DCI组.多变量logistic回归分析显示,低GCS评分(OR 8.92,95％ CI 2.48 ～26.94;P ＜0.001)、高Fisher分级(OR 7.49,95％ CI 1.96～20.47;P＜0.001)是DCI的独立危险因素,而接受尼莫地平+依达拉奉治疗是DCI的独立保护因素(OR0.27,95％ CI 0.08 ～0.97;P =0.020).结论 与单用尼莫地平相比,尼莫地平与依达拉奉联合应用可显著降低CVS和DCI发生率.GCS评分、高Fisher分级和高血压是aSAH患者发生CVS和DCI的独立危险因素,而尼莫地平与依达拉奉联合应用是其独立保护因素.     

蛛网膜下腔出血患者预防性应用尼莫地平有效性和安全性的Meta分析（下）

目的 评价尼莫地平预防动脉瘤性蛛网膜下腔出血（SAH）患者脑血管痉挛的有效性及安全性.方法 检索Pubmed、OVID、EMBase、Cochrane library、卒中临床试验注册及国家科技图书文献中心数据库,检索截止时间均为2010年11月.收集尼莫地平被预防性用于动脉瘤性蛛网膜下腔出血患者的前瞻性随机临床对照试验,对符合纳入标准的研究进行Meta分析.结果 有8项研究符合纳入标准,1499例患者接受了不同指标的试验观察.与安慰剂组比较,尼莫地平组（所有病例）的完全康复率增加了64%[P=0.0002,OR=1.64,95%CI：1.26～2.13;需要治疗的患者数（NNT）：-1.048],完全康复或中等残疾率增加了79%（P=0.0007,OR=1.79,95%CI：1.28～2.51;NNT=-5.889）,死亡、严重残疾或植物状态发生率降低了38%（P=0.0003,OR=0.62,95%C/：0.48～0.80;NNT=1.529）;脑血管痉挛（CVS病例）的病死率降低了74%（P=0.008,OR=0.26,95%CI：0.09～0.71;NNT=2.298）;症状性CVS的发生率降低了46%（P〈0.00001,OR：0.54,95%CI：0.42～0.69;NNT=1.952）;迟发性神经功能缺损（所有病例）发生率降低了38%（P〈0.0001,OR=0.62,95%C/：0.50～0.78;NNT=1.078）;症状性脑梗死的发生率降低了46%（P〈0.00001,OR：0.54,95%C/：0.42～0.69;NNT=1.079）;经CT证实的脑梗死的发生率为安慰剂组的58%（P=0.001,OR=0.58,95%CI：0.42～0.81;NNT=3.314）;CVS病例脑梗死的发生率为安慰剂组的35%（P=0.003,OR：0.35,95%CI：0.17～0.69;NNT=3.688）,脑梗死（所有病例）发生率为安慰剂组的52%（P〈0.00001,OR=0.52,95%CI：0.41～0.66;NNT=1.196）;尼莫地平组与安慰剂组再出血和不良反应发生率的差异均无统计学意义（再出血：P=0.15,OR=0.75,95%CI：0.50～1.11;不良反应：JP=0.59,OR=1.13,95%CI：0.71～1.81）.结论 与安慰剂比较,尼莫地平可显著改善动脉瘤性SAH患者的临床转归,可降低症状性CVS、迟发性神经功能缺损以及脑梗死的发生率,而再出血和不良反应的发生率与安慰剂相当.     

动脉瘤性蛛网膜下腔出血患者分流依赖性脑积水的预测因素和预测评分

分流依赖性脑积水(shunt-dependent hydrocephalus, SDHC)是动脉瘤性蛛网膜下腔出血(aneurysmal subarachnoid hemorrhage, aSAH)的常见严重并发症。aSAH后SDHC发生率为9%～36%, 且与患者转归不良相关。文章对aSAH后SDHC的预测因素和预测评分进行了综述。     

法舒地尔对动脉瘤性蛛网膜下腔出血患者血浆ET-1水平的影响及作用机制探讨

目的观察法舒地尔对动脉瘤性蛛网膜下腔出血（aSAH）患者血浆内皮素-1（ET-1）水平的影响,探讨其作用机制。方法 70例aSAH患者,随机分为观察组34例（常规治疗＋法舒地尔）和对照组（常规治疗）,各35例。两组均于发病后1、3、7、10、14 d采集静脉血。另选15例健康查体者为正常对照（正常组）,查体时一次性采集。用放射免疫分析法测定血浆中ET-1,用经颅多普勒超声（TCD）检测大脑中动脉（MCA）的流速。结果观察组aSAH后1～10 d、对照组在aSAH后1～14 d时的血浆ET-1均高于正常组（P均〈0.05）,aSAH后14 d时观察组血浆ET-1水平与正常组相当（P〉0.05）,aSAH后1 d时的血浆ET-1水平观察组与对照组近似（P〉0.05）,3～14 d时观察组血浆ET-1水平明显低于对照组（P〈0.05）。观察组aSAH后发生脑血管痉挛4例、对照组16例（P〈0.05）。结论法舒地尔能降低aSAH患者血浆ET-1水平,这可能是其预防脑血管痉挛发生的机制之一。     

β受体阻滞剂在慢性阻塞性气道疾患中应用的荟萃分析

目的 通过荟萃分析总结β受体阻滞剂在合并有慢性肺部疾病及心血管疾病患者中的使用利弊.方法 检索中西文数据库(PUBMED、MEDLINE、OVID、ELSEVIER、中国期刊数据库和万方数据库).对入选文献做资料提取,并总结分析.结果 共有76篇论文入选,英文72篇,中文4篇;关于在合并慢性阻塞性肺疾病及心血管疾病中使...     

What do we know about benefits of H. pylori treatment in childhood?

Policy analysis shows that H. pylori test and treat strategies targeting adults at moderate to high risk of H. pylori-induced disease is likely to be cost-effective for preventing digestive diseases responsible for a large global disease burden. Little is known, however, about health benefits to children from eliminating this infection. We conducted a systematic review of the evidence regarding health benefits to children from treatment to eliminate H. pylori infection.

We systematically searched Ovid MEDLINE for pertinent review articles published through 2012. We excluded reviews focused on treatment efficacy and scrutinized reference lists of selected reviews to identify additional eligible reviews.

Fifteen reviews met specified inclusion criteria. Overall, they show that few reported studies investigating pediatric health effects of treatment for H. pylori infection were well designed with adequate statistical power. Thus, there is insufficient evidence for drawing conclusions about health benefits to children from treatment to eliminate H. pylori infection.     

Diagnostic value of anti-cyclic citrullinated peptide antibody for rheumatoid arthritis in a Chinese population: a meta-analysis

To use meta-analysis to determine the accuracy of anti-cyclic citrullinated peptide (CCP) antibody in diagnosis of patients with rheumatoid arthritis (RA) in a Chinese population, we searched MEDLINE and CNKI databases for studies published in English or Chinese between January 2000 and June 2010. Two investigators independently evaluated studies for inclusion, data extraction, and quality assessment. We used a random-effects model to combine estimates of sensitivity, specificity, positive likelihood ratio (LR+), negative likelihood ratio (LR-), and diagnostic odds ratio (DOR). One hundred and eighteen studies met our inclusion criteria. All studies were of high quality. The summary estimates for anti-CCP antibody in the diagnosis of RA in a Chinese population were as follows: sensitivity 0.65 (95% confidence interval (CI) 0.65-0.66), specificity 0.95 (95% CI 0.95-0.96), positive likelihood ratio (LR+) 15.84 (95% CI 13.55-18.54), negative likelihood ratio (LR-) 0.33 (95% CI 0.31-0.35), and diagnostic odds ratio (DOR) 51.60 (95% CI 43.64-61.01). With high specificity and moderate sensitivity, anti-CCP antibody tests play an important role in conforming the diagnosis of RA in a Chinese population.     

The impact of geriatric post-discharge services on mental state.

OBJECTIVE: To determine the impact of geriatric post-discharge services on mental state. METHODS: Three computer databases, MEDLINE, HealthSTAR and the Cochrane Database of Systematic Reviews were searched for relevant articles; the bibliographies of retrieved articles were searched for additional references. RESULTS: 11 trials were located that met the four inclusion criteria: (i) original study; (ii) published in English or French; (iii) controlled trial (randomized or non-randomized) of a geriatric post-discharge service; and (iv) including at least one measure of mental state. All trials met most of the validity criteria for intervention studies of the Evidence-Based Medicine Working Group. Three trials reported a small effect on emotional state or self-perceived health and eight trials reported no effect. CONCLUSION: There is little evidence that geriatric post-discharge services have an impact on the mental state of aged subjects. Future services and studies should be designed to address the issue of mental state outcomes in this population.     

利奈唑胺治疗耐多药结核病的初步评价

目的 初步评价利奈唑胺治疗耐多药结核（MDR-TB）的有效性与安全性。方法 检索Cochrane图书馆临床对照试验库、Pubmed、Embase、CBM、CNKI、Wanfang Date等电子数据库。对符合纳入标准的临床研究进行统计分析。结果 共有７个国家的5个临床研究符合纳入标准。分析结果表明,含利奈唑胺的联合化疗方案治疗MDR-TB的合并成功率为82%（95%CI 73%～89%）;治疗结果为失败、丢失或死亡的比例分别为2%、5%、11%。血液系统不良反应、神经毒性和胃肠道反应的发生率分别为32%、25%、6%。结论 利奈唑胺对耐多药结核病有较好的疗效,但药物不良反应发生率较高。     

蛛网膜下腔出血患者预防性应用尼莫地平有效性和安全性的Meta分析（上）

目的评价尼莫地平预防动脉瘤性蛛网膜下腔出血（SAH）患者脑血管痉挛的有效性及安全性。方法检索Pubmed、OVID、EMBase、Cochrane library、卒中临床试验注册及国家科技图书文献中心数据库,检索截止时间均为2010年11月。收集尼莫地平被预防性用于动脉瘤性蛛网膜下腔出血患者的前瞻性随机临床对照试验,对符合纳入标准的研究进行Meta分析。结果有8项研究符合纳入标准,1499例患者接受了不同指标的试验观察。与安慰剂组比较,尼莫地平组（所有病例）的完伞康复率增加丁64％[P=0．0002,OR=1．64,95％CI：1．26～2．13;需要治疗的患者数（NNT）=-1．048],完全康复或中等残疾率增加了79％（P=0．0007,OR=1．79,95％CI：1．28～2．51;NNT=-5．889）,死亡、严重残疾或植物状态发生率降低了38％（P=0．0003,OR=0．62,95％C1：0．48—0．80;NNT=1．529）;脑血管痉挛（CVS病例）的病死率降低了74％（P=0．008,OR：0．26,95％CI：0．09～0．71;NNT=2．298%。症状性CVS的发生率降低了46％（P〈0．00001,OR：0．54,95％CI：0．42～0．69;NNT=1．952）;迟发性神经功能缺损（所有病例）发生率降低了38％（P〈0．0001,OR=0．62,95％CI：0．50～0．78;NNT=1．078）;症状性脑梗死的发生率降低了46％（P〈0．00001,OR=0．54,95％C1：0．42～0．69;NNT=1．079）;经CT证实的脑梗死的发生率为安慰剂组的58％（P=0．001,OR=0．58,95％C1：0．42～0．81;NNT=3．314）;CVS病例脑梗死的发生率为安慰剂组的35％（P=0．003,OR=0．35,95％CI：0．17～0．69;NNT=3．688）,脑梗死（所有病例）发生率为安慰剂组的52％（P〈0．00001,OR=0．52,95％CI：0．41～0．66;NNT=1．196）;尼莫地平组与安慰剂组再出血和不良反应发生率的差异均无统计学意义（再出血：P=0．15,OR=0．75,95％CI：0．50～1．11;不良反应：P=0．59,OR=1．13,95％CI：0．71～1．81）。结论与安慰剂比较,尼莫地平可显著改善动脉瘤性SAH患者的临床转归,可降低症状性CVS、迟发性神经功能缺损以及脑梗死的发生率,而再出血和不良反应的发生率与安慰剂相当。     

The incidence of sexually acquired reactive arthritis: a systematic literature review

Reactive arthritis (ReA) is an inflammatory spondyloarthritis occurring after infection at a distant site. Chlamydia trachomatis is proposed to be the most common cause of ReA, yet the incidence of sexually acquired ReA (SARA) has not been well established. We therefore carried out a systematic literature review to collate and critically evaluate the published evidence regarding the incidence of SARA. MEDLINE and EMBASE databases were searched using free-text and MeSH terms relating to infection and ReA. The title and abstract of articles returned were screened independently by two reviewers and potentially relevant articles assessed in full. Data was extracted from relevant articles and a risk of bias assessment carried out using a validated tool. Heterogeneity of study methodology and results precluded meta-analysis. The search yielded a total of 11,680 articles, and a further 17 were identified from review articles. After screening, 55 papers were assessed in full, from which 3 met the relevant inclusion criteria for the review. The studies reported an incidence of SARA of 3.0–8.1 % and were found to be of low to moderate quality. More studies are required to address the lack of data regarding the incidence of SARA. Specific and sensitive classification criteria must be developed in order for consistent classification and valid conclusions to be drawn. In clinical practice, it is recommended clinicians discuss the possibility of ReA developing at the time of STI diagnosis and to encourage patients to return if they experience any relevant symptoms.     

The accuracy of noncontrast helical computed tomography versus intravenous pyelography in the diagnosis of suspected acute urolithiasis: a meta-analysis

STUDY OBJECTIVES: We determine the accuracy of noncontrast helical computed tomography (NHCT) compared with that of intravenous pyelography (IVP) in diagnosing acute urolithiasis. METHODS: Computerized searches of MEDLINE and EMBASE were combined with hand reviews of major journals and of articles from reference lists. Articles were assessed according to a priori criteria for inclusion. Study eligibility was independently assessed by 2 reviewers in a blinded fashion. Test results were combined and analysis of log-transformed data was conducted by using general linear models. RESULTS: No disagreement was found between the 2 investigators in terms of articles that met the inclusion criteria or between the results of the studies. Four studies involving a total of 296 patients met all of the a priori criteria. The pooled positive likelihood ratios (LR+) for NHCT and IVP are 23.15 (95% confidence interval [CI] 11.53 to 47.23) and 9.32 (95% CI 5.23 to 16.61), respectively. The pooled negative likelihood ratios (LR-) for NHCT and IVP are 0.05 (95% CI 0.02 to 0.15) and 0.33 (95% CI 0.23 to 0.48), respectively. The differences between NHCT and IVP were statistically significant for both LR+ (P =.046) and LR- (P =.013). Differences among trials were not statistically significant in either analysis (P =.125 for LR+; P =.114 for LR-). CONCLUSION: The studies analyzed consistently demonstrated NHCT to be superior to IVP in accurately diagnosing acute urolithiasis, and differences between the 2 tests for both LR+ and LR- were statistically significant.     

Brief report: Incidence, etiology, risk factors, and outcome of hospital-acquired fever a systematic, evidence-based review

OBJECTIVES: Temperature is universally measured in the hospitalized patient, but the literature on hospital-acquired fever has not been systematically reviewed. This systematic review is intended to provide clinicians with an overview of the incidence, etiology, and outcome of hospital-acquired fever. DATA SOURCES: We searched MEDLINE (1970 to 2005), EMBASE (1988 to 2004), and Web of Knowledge. References of all included articles were reviewed. Articles that focused on children, fever in the developing world, classic fever of unknown origin, or specialized patient populations were excluded. REVIEW METHODS: Articles were reviewed independently by 2 authors before inclusion; a third author acted as arbiter. RESULTS: Of over 1,000 studies reviewed, 7 met the criteria for inclusion. The incidence of hospital-acquired fever ranged from 2% to 17%. The etiology of fever was infection in 37% to 74%. Rates of antibiotic use for patients with a noninfectious cause of fever ranged from 29% to 55% for a mean duration of 6.6 to 9.6 days. Studies varied widely in their methodology and the patient population studied. CONCLUSIONS: Limited information is available to guide an evidence-based approach to hospital-acquired fever. We propose criteria to help standardize future studies of this important clinical situation.