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Consensus guidelines recommend the use of either dopamine or norepinephrine as first-line therapy for patients with shock, but recent observational evidence suggests norepinephrine may be associated with better outcomes.
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In this issue: Fractures and bisphosphonate therapy, warfarin anticoagulation and influenza vaccine and cotrimoxazole, antiplatelet therapy with clopidogrel and aspirin, FDA Actions.
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A retrospective observational study was conducted on 30 individuals from a possible 49 persons who were treated for schistosomiasis between 2003 and 2008 at Copenhagen University Hospital, Denmark. All patients had traveled to endemic areas and had been previously diagnosed by detection of ova or positive serologic studies associated with symptoms.
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The characteristics and morbidities of 1591 children who presented to travel and tropical medicine clinics for care in 19 countries following international visits to 218 destinations were investigated as part of the GeoSentinel Surveillance Network research activities.
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In March 2009, 89 active-duty U.S. trainees received yellow fever (YF) vaccination as part of standard preparation for potential travel to sub-Saharan Africa and Central and South America.
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A 7.0 magnitude earthquake struck Haiti on Jan. 12, 2010, with an epicenter 10 miles west of Port-au-Prince, the capital. Approximately 200,000 fatalities occurred, and 500,000 people were left homeless. From Jan. 12 to Feb. 25, 11 laboratory-confirmed cases of Plasmodium falciparum malaria acquired in Haiti were reported to the CDC.
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In this large retrospective cohort study of more than 100,000 patients in 112 hospitals, after correction for illness severity and other factors, daily rounds by a multidisciplinary care team were associated with lower mortality in the ICU, regardless of whether an intensivist model of physician staffing was in use.
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The risk of relapse after effective therapy with plasma exchange for thrombotic thrombocytopenic purpura (TTP) has not been well-characterized. Among 376 patients with an initial episode of TTP treated with plasma exchange, overall survival was around 68%, with a survival of 78% among the subset with idiopathic TTP. Survival did not differ on those having a low (< 10%) ADAMTS13 level. Relapse was greater for those with a low ADAMTS13 level at the time of presentation.
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In a prospective, observational study, > 50% of patients identified and treated for severe sepsis in the emergency department (ED) had negative cultures; 18% of patients had a noninfectious diagnosis that mimicked sepsis.
