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Markers and Mechanisms of Chronic Fatigue Following Mononucleosis
Chronic disabling fatigue affects up to 2% of adolescents and often follows Epstein-Barr virus-related mononucleosis. No clinically significant infectious, immune, neuroendocrine, or autonomic biomarker or pathophysiologic mechanism has been identified to differentiate those with mononucleosis who go on to develop chronic fatigue from those who recover.
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Cefazolin and Ertapenem as Salvage Therapy in Methicillin-Susceptible Staphylococcus aureus Bacteremia
Cefazolin (CZ) and ertapenem combination therapy was successfully used to salvage 11 cases of persistent methicillin-susceptible Staphylococcus aureus bacteremia. Modest in vitro synergy between CZ and ertapenem was demonstrated on testing of six clinical isolates, but in vivo activity appeared more potent in an animal model than as predicted by in vitro activity.
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Fulminant Clostridioides difficile Infection: Hold the IV Metronidazole?
The combination of oral vancomycin and intravenous metronidazole is not superior to vancomycin alone in the treatment of fulminant infection due to Clostridioides difficile.
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What Is the Risk of Joint Prosthesis Infection Resulting From Bacteremia?
The risk of periprosthetic joint infection resulting from bacteremia depends on the organism.
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Preventing Readmissions and Optimizing Outcomes for Staphylococcus aureus Bacteremia: Still a Long Journey Ahead
Using a population-based database, investigators found that the rate of readmission within 30 days following hospitalization for S. aureus bacteremia was high (22%) and resulted in high cost to the healthcare system.
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Sports-Related Concussion
Media coverage of professional athletes experiencing irreversible damage after repeated brain trauma and of the underreported rates and risks of pediatric concussion have heightened awareness surrounding head injury in sports and recreation. Concussion is now known to be a significant public health issue, with high rates of emergency department visits and hospitalizations. Much of the current concern surrounding concussions revolves around recognition, early diagnosis, treatment modalities, return-to-play, and prevention of recurrent concussions.
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Predicting the Progression of Chronic Aortic Regurgitation
A large database observational study of patients with chronic aortic mild or moderate regurgitation (AR) largely due to bicuspid aortic valve or aortic root dilatation showed that it was largely an indolent disease, with only 20% progressing to moderately severe AR in five years.
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Perioperative Management of Direct Oral Anticoagulants
A simple protocol for managing atrial fibrillation patients on direct oral anticoagulants perioperatively was shown to produce low levels of major bleeding and thromboembolism for 30 days postoperatively.
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CRT Nonresponders Experience Poor Outcomes, Warrant More Aggressive Management
The ADVANCE CRT registry revealed a significant minority of patients fail to respond to cardiac resynchronization therapy, conferring a worse prognosis.
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Is the Physical Exam an Anachronism in Heart Failure?
In the PARADIGM-HF trial, signs of congestion during physical exam were related to outcomes and the improved outcomes observed with valsartan/sacubitril vs. enalapril.