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Combination Therapy of MRSA Bacteremia Was Not Beneficial in a Randomized Clinical Trial
In a randomized clinical trial conducted at 27 hospitals in four countries, researchers found that the addition of an antistaphylococcal beta-lactam to vancomycin or daptomycin (99% received vancomycin) did not lead to improved outcomes in MRSA bacteremia. The trial was stopped early because of safety concerns, including a higher risk of acute kidney injury in the combination group.
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Quantifying the Risk of SARS-CoV-2 Transmission in the United States
In the United States, the rate of symptomatic transmission of SARS-CoV-2 to contacts was only 0.45%, but was 10.5% in household contacts; there were tertiary symptomatic transmissions. However, since only symptomatic individuals underwent testing, the actual overall rate of transmission with or without resultant symptomatic illness is likely to be higher.
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Pharmacotherapy Considerations for COVID-19
This article provides a brief summary of selected pharmacotherapy options proposed for COVID-19.
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17P to Prevent Recurrent PTB in Singleton Gestations: The PROLONG Study
In this large, double-blind, placebo-controlled, international trial, pregnant women at risk for preterm birth (PTB) between 16-36 weeks gestational age were randomized to an intramuscular weekly injection of either 17-hydroxyprogesterone caproate (17P) or placebo. There was no difference in rates of PTB or neonatal morbidity between these two groups. In comparison to the Meis trial published in 2003, the findings of the PROLONG trial question the use of intramuscular 17P injection as the cornerstone of PTB prevention.
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Vaginal Dryness: The Keystone Symptom of Postmenopausal Sexual Dysfunction?
In a large, cross-sectional, multicenter study in Italy that evaluated factors predictive of sexual dysfunction, vaginal dryness correlated independently and negatively with each Female Sexual Function Index domain.
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Can We Liberalize Intrauterine Device Insertion Protocols?
In this retrospective cohort study, the rate of luteal phase pregnancy was 0.4% among 239 women who did not meet pregnancy checklist criteria for intrauterine device insertion.
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Early Loss of Ovarian Function May Increase Risk for Cardiovascular Disease
Natural and surgical menopause appear to be associated with an increased risk for cardiovascular disease.
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Diabetes in Pediatric ED Patients
Emergency medicine providers commonly will encounter children with type 1 and type 2 diabetes. Unfortunately, the incidence of both is increasing, and the acute care provider must be able to recognize the subtle and dramatic presentations of both diseases. Early recognition and management of both the disease and its complications — diabetic ketoacidosis, hyperglycemic hyperosmolar state, and cerebral edema — are critical to ensure an optimal outcome.
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Plaintiff Expert Worked in the ED, But Only During Residency Rotation
Plaintiff attorneys frequently bring in experts with specific knowledge from whatever specialty is relevant to the condition that was missed or managed inappropriately. When an emergency physician saw a patient, he or she had to take the patient as a whole and consider every possible diagnosis. Unlike other specialties, emergency physicians do not get to pick and choose the kind of patients or complications they see.
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‘Copy and Paste’ Can Legally Compromise Entire ED Record
When information is copied and pasted into the ED chart, it can improve patient care because all providers are aware of the patient’s history — or it can legally compromise the entire medical record.