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In this issue: Side effects of statins; effects of cannabis use; antihypertensives and lip cancer; and FDA actions.
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Menopausal women anecdotally report that their hot flashes are worse with stress;1 for instance, if a woman has an unpleasant confrontation, she notices that it will trigger a hot flash. Research supports these anecdotal experiences. Lab stressors such as arithmetic tasks can also increase hot flashes. When women are randomized to a lab stressor condition vs a non-stress condition, those in the stress condition have 47-57% more hot flashes.2 Women are not just reporting more hot flashes during periods of stress; objective measurements of hot flashes confirm the increase during stress conditions. Stress appears to lower the threshold for hot flashes to occur.
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Another Look at Bleeding Risk from Aspirin; Can Aspirin Prevent Recurrence of Thromboembolism?; A New Approach to Tinnitus; Coffee Might be One Less Thing We Have to Worry About; ED, Lower Urinary Tract Symptoms, and Ejaculatory Dysfunction; The Allure of Shared Medical Appointments in Diabetes Care
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In this study in which all patients with clinically suspected ventilator-associated pneumonia were given prompt empiric antibiotic therapy, whether that therapy turned out to be appropriate for the organisms recovered turned out to be an important determinant of patient outcomes.
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This article provides many excellent suggestions and strategies for improving communication among the members of the critical care team to reduce medical errors.
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The increasing prevalence of antibiotic resistance in urinary pathogens has led Hooton and colleagues to examine the efficacy of a relatively broad spectrum orally administered cephalosporin in the treatment of uncomplicated cystitis.
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Interpret the rhythm strip shown above. The widened beats on the tracing are not ventricular. What else might they be?
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Patients with preterm contractions, who subsequently were diagnosed to have false labor and discharged, do not have an increased risk for early preterm birth, neonatal mortality, or lower Apgar scores. However, they do have a slightly greater chance of delivering in the late preterm period (34 to 36 weeks).
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Currently, screening for fetal aneuploidy involves a variety of first-line methods that put into play combinations of maternal serum analytes and ultrasound exams in the first and second trimester, with invasive procedures such as chorionic villus sampling (CVS) and amniocentesis being reserved for those at higher risk by history, age, or worrisome results from first-line screening. As will be discussed, each screening combination comes with its own predictive accuracy and now patients and providers can choose from a buffet of screening options, including going right to the main course (amniocentesis or CVS) if one wants 100% accuracy at a small risk of fetal loss (we quote a 1 in 400 risk with amniocentesis and about a 1 in 100 risk for CVS).
