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  • Differential Time to Positivity Is a Useful Measure in Diagnosing Central Line-Associated Bloodstream Infections

    A systematic review and meta-analysis found differential time to positivity (DTP) was a useful measurement in confirming or excluding central line-associated bloodstream infections (CLABSIs). However, DTP was not as accurate for CLABSIs resulting from Staphylococcus aureus (lower sensitivity) or Candida spp. (lower specificity) compared to other organisms.

  • Novel Oral Amphotericin B Formulation Shows Promise for Cryptococcal Meningitis

    A randomized, controlled trial by Boulware and colleagues demonstrated that a new oral lipid nanocrystal formulation of amphotericin had similar antifungal activity and survival rates but significantly less toxicity compared to intravenous amphotericin when used as induction therapy for human immunodeficiency virus-associated cryptococcal meningitis.

  • Infectious Disease Alert Updates

    Cardiac Effects of Bedaquiline and Delamanid in Combination; Is Leprosy ‘Endemic’ in Florida?; Linezolid Dosing in Cardiac Surgery

  • Malpractice Claims Against Emergency Residents Allege Lack of Supervision

    Although time and resources are tight, attendings and residents must work together closely to prevent litigation.

  • Blood Pressure Management After Endovascular Thrombectomy: What Is the Best Number?

    Approximately 50% of patients who undergo endovascular therapy for ischemic stroke still have a severe impairment or will die within 90 days. Therefore, additional interventions are being investigated to improve overall outcome. Current guidelines from the American Heart Association suggest maintaining systolic blood pressure below 180 mmHg for patients who were treated both with intravenous thrombolysis and endovascular thrombectomy. A number of centers around the world have tried different systolic blood pressure thresholds ranging from 120 mmHg to 160 mmHg. Many of these studies have been single-center or small non-randomized studies and have not been designed to get a definitive answer.

  • Tenecteplase vs. Alteplase for Treatment of Acute Ischemic Stroke: It Is Time to Make the Change

    Since 1996, when the U.S. Food and Drug Administration approved the use of intravenous alteplase for the treatment of acute ischemic stroke, there has been a steady increase in the adoption of both intravenous thrombolysis as well as endovascular thrombolysis and mechanical thrombectomy for the treatment of patients with acute ischemic stroke and large vessel occlusion. There now is extensive experience with the use of tenecteplase for the treatment of acute ischemic stroke. It has been shown to be equally efficacious, with a similar risk profile as alteplase.

  • Radiosurgery vs. Watch-and-Wait Approach for Newly Diagnosed Vestibular Schwannoma

    Vestibular schwannoma is the most common tumor of the cerebellopontine angle. There is controversy regarding the management of these benign tumors with up-front radiosurgery vs. observation, especially for those that are small- to medium-sized with minimal symptoms. Recent evidence suggests that up-front radiosurgery may reduce tumor volume at four-year follow-up.

  • Nitrous Oxide-Induced Neuropathy

    Nitrous oxide-induced neuropathy presents with a rapidly progressive sensorimotor neuropathy that may mimic Guillain-Barré syndrome. The pattern of clinical weakness and progression, as well as electrophysiological features, can help to rapidly distinguish the two disorders.

  • Comparison of the Efficacy of Rituximab vs. Ocrelizumab in the Treatment of Relapsing Multiple Sclerosis

    Rituximab is an anti-CD20 chimeric monoclonal antibody used off-label to treat multiple sclerosis (MS). Ocrelizumab is a humanized monoclonal anti-CD20 monoclonal antibody that is Food and Drug Administration-approved for the treatment of MS. In this observational cohort study, the authors were not able to demonstrate noninferiority of rituximab compared to ocrelizumab because of a significantly lower relapse rate in the ocrelizumab-treated group.

  • Burning Down the House: Climate Change Drives Emerging Infections

    The connection between emerging infections and climate change has gone from theoretical discussions in the past few years to an evidence-based phenomenon happening in real time. That said, there are multiple converging factors, and attributing all emerging infections to global warming is too broad a stroke to explain a complex issue.