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In this issue: Antiviral drugs and birth defects, bisphosphonates and esophageal cancer, naltrexone plus bupropion for weight loss, 2010-11 influenza vaccine, FDA Actions.
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All emergency physicians are comfortable caring for the patient in acute pulmonary edema. Initial treatment of this emergency condition has changed little in the past decade. However the treatment of less acute patients with congestive heart failure (CHF) has changed dramatically in the recent past.
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Autochthonous transmission of dengue virus infection has been detected in Florida.
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In this before-and-after study of more than 275,000 patients admitted to a Swedish hospital before-and-after implementation of a medical emergency team, in-hospital cardiac arrests decreased and overall in-hospital mortality fell by 10% in the two years following the team's implementation.
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There is no difference in rates of treatment failure, death, or readmission for COPD between patients treated with oral or intravenous steroids for exacerbation of COPD, but the IV route may be associated with increased cost and length of stay.
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The etiology of blood culture-negative endocarditis was identified in 62.7% of 759 patients using combinations of serological, molecular, and histopathological assays. The majority of the agents not detected by conventional cultures were Coxiella burnetii (30%) and Bartonella spp. (11%), both diagnosed using serological tests, and Trophyrema whipplei, other unusual bacteria, and fungi making up the remainder. For 14% of patients, diagnosis required PCR testing on valve tissue removed during surgery (not in paraffin). The cause of disease could not be determined for 264 patients; 2% of patients had non-infectious endocarditis.
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This meta-analysis casts serious doubt on the ability of rapid response teams to significantly reduce hospital mortality.
