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Fatigue occurs commonly in patients with cancer, particularly when receiving chemotherapy or radiation. Furthermore, in long term survivors, persistent fatigue occurs in up to one third. Although anemia is one contributing factor, fatigue certainly occurs in its absence as well. Two recent reports are reviewed; one addressing the mechanisms and biochemical markers of persistent fatigue, and the other introducing a novel therapeutic approach directed at chemotherapy-associated fatigue. It is quite apparent that dysregulation of inflammatory mechanisms accounts for some component of fatigue and anti-inflammatory treatments may be of great value.
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In a retrospective analysis, medical ICU patients requiring mechanical ventilation for 2 days or more had lower ICU and hospital mortality (but more ventilator-associated pneumonia) if they were begun on enteral feeding during that time than if they were not.
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A prospective randomized trial carried out over a 6-year period of time enrolled 180 patients with ARDS of at least 7 days duration, and randomized them to receive either methylprednisolone or placebo. There was no significant difference noted in mortality at 60 days, though there was some improvement in ventilator-free and shock-free days during the first 28 days in patients treated with steroids. Steroids were also associated with an increased risk of death if started more than 2 weeks after the onset of ARDS.
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Methicillin-resistant Staphylococcus aureus (MRSA) in the community was the cause of the majority of skin and soft tissue infections, and was predominantly of one strain different from MRSA of hospital origin.
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Air Travel and DVT Risk: Is Hypobaric Hypoxia the Culprit?; GERD: Size Matters; Does aTNFa for RA Increase Infections and Malignancies?; Postexposure Treatment with Doxycycline and Tick-Borne Relapsing Fever; Secondary Prevention of Stroke: Persistence Pays Off; That Darned Cold Sore: What a Difference a Day Makes!
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Cleansing patients with chlorhexidine-saturated cloths reduced VRE contamination of patients' skin, the environment, and health care workers' hands, and also decreased VRE acquisition.
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A return to full normal activities, including work at 2 weeks, after AMI appears to be safe in patients who are stratified to a low-risk group. This should have significant medical and socioeconomic implications.
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The number of previous acute exacerbations of chronic bronchitis (AECBs) and the baseline FEV1 level are potent prognostic factors of the short- and long-term outcomes of AECB.
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The results of this study underline the uncertainty regarding the risk/benefit ratio of rtPA treatment in acute stroke in patients older than 80 years of age.
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Six patients developed lactic acidosis during prolonged linezolid therapy, possibly as the result of mitochondrial protein synthesis.
