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Isolated pulmonic valve endocarditis is the topic of an interesting article from the Cleveland Department of Veterans Affairs Medical Center. Hamza and colleagues reported 3 of their own cases, involving men ages 47, 64, and 76, none of whom were intravenous drug addicts (IVDA). In 2 of the patients, Enterococcus faecalis was the causative pathogen, and in the other patient, a coagulase-negative staphylococcus was the pathogen.
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Rifaximin (Xifaxan) has rreceived US FDA approval on May 25, 2004, for the treatment of travelers diarrhea caused by enteropathogenic (non-invasive) Eschericiha coli in individuals at least 12 years of age. Rifaximin is a rifamycin that is poorly absorbed (< 0.4%) from the gastrointestinal tract, and thus achieves very high concentrations in the feces.
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Erythromycin use is associated with a 2-fold increased risk of sudden cardiac death and a 5-fold increase in those who concurrently receive other medications that significantly inhibit its metabolism by CYP3A4.
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Five days of oral treatment with azithromycin appeared to be at least as effective as a similar duration of treatment of treatment with ceftriaxone in children in Cairo with typhoid fever.
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If your ED handles 15,000 to 20,000 pediatric patients a year, it might be time to consider adding a child life specialist to your staff. These specialists, say observers, can increase cooperation and compliance with medical staff, can prove invaluable in pain management, significantly improve patient and family satisfaction, and set you apart from the competition.
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The Agency for Healthcare Research and Quality (AHRQ) has released a tool to help quickly locate alternate health care sites if hospitals are overwhelmed by patients due to a bioterrorism attack or other public health emergency.
