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U.S. Caregiver Received Experimental Ebola Vaccine Post Exposure
An American caregiver exposed to the Ebola virus while caring for a patient in Africa was given the new experimental vaccine within 24 hours and subsequently did not develop infection. As is often the case with diseases calling for post-exposure prophylaxis, it cannot be determined whether the vaccine prevented infection or whether the patient would not have developed Ebola regardless. -
CDC Analysis Supports Mandated Drug Stewardship in Hospitals
A new analysis of the immense societal costs of Clostridioides difficile infection may spur the Centers for Medicare & Medicaid Services to finalize a regulation requiring antibiotic stewardship in hospitals.
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Precise Localization of Focused Ultrasound Thalamotomy Determines Clinical Benefit
Lesioning of the posterior portion of the VIM thalamus is most efficacious. Lesions extending beyond this portion can lead to adverse side effects in those with essential tremor treated with MRI-guided focused ultrasound.
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Miller Fisher Syndrome: Atypical Features
Other than the classic triad of neurological signs that define Miller Fisher syndrome, it also is common to see delayed facial palsy, loss of taste, and weakness of pharyngeal and cervical muscles.
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Treatment of Acute Migraine With Ginger
Ginger extract has a long anecdotal history as a treatment for migraine headaches in traditional Chinese medicine. This well-designed study provides evidence that adding ginger to a standard nonsteroidal anti-inflammatory medication improves outcomes of migraine treatment by all measured parameters.
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Clinicians Believe Chaplains Helpful — But Call on Them Infrequently
One study found that chaplain consults were rare, mainly reserved for dying patients, and usually occurred in the last 24 hours of life or even after death.
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Providers Experience Moral Distress in Pediatric Mental Healthcare
Limited community resources, such as lack of available inpatient beds, are among the issues facing clinicians.
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Proceedings From the International Stroke Conference, Honolulu, February 2019
The following reviews of studies presented at the 2019 International Stroke Conference were written after my personal attendance at the presentations, followed by review of the simultaneous publications in The New England Journal of Medicine and The Lancet. All comments and opinions are solely those of this editor. — Matthew E. Fink, MD
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‘Tremendous Need’ for Research on EMRs and Advance Care Plans
Despite the proliferation of EMRs, there is little evidence of how useful they are in improving advance care planning.
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Updated Ethics Manual Addresses Many New Realities in Clinical Practice
Genetic testing, the protection of human subjects, social media professionalism, precision medicine and genetics, telemedicine, and physician volunteerism are just some of the ethical challenges clinicians now face.