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One of the most common manifestations of disease, fever in children remains controversial, misunderstood, and often is thought to be mysterious. The clinician always should realize that fever is not a disease itself, but a manifestation of a number of different disease processes. Because there are substantial differences in the cause and outcome of fever-generating illnesses in children of different ages, the discussion must consider age. Not surprisingly, there is a diversity of approaches to fever.
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As medical practitioners mature with experience, many discover that what was taught in medical school — History is the most important part of the patient encounter — is actually true. Yet, taking a history is a practiced skill even for the examiner who speaks the same language as the patient. The problems encountered with taking a history from a patient are compounded exponentially when the examiner and the patient are not skilled in speaking the same language. In this issue, the author explores numerous facets of caring for patients who speak a language other than the physician’s language.
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In this study from Rush University Medical Center in Chicago, Duckro and colleagues carried out a careful molecular epidemiologic study of the transmission of vancomycin-resistant enterococci (VRE) to the hands of health care workers from both intact skin areas of VRE-colonizes patients and various environ mental surfaces in the patients vicinity.
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Acute renal failure, characterized by sudden loss of the ability of the kidneys to excrete waste, concentrate urine, conserve electrolytes, and maintain fluid balance, is a frequent clinical problem.
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The emergency department physician is continually challenged to identify children who may have sustained an injury secondary to abuse. Reaching a balance between protecting a child from possible harm and putting a family through the ordeal of an unwarranted investigation is challenging. This article reviews the common patterns of injury that should raise concern for abuse.
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Is Holding NSAIDs Prior to Surgery Rational?; Low-Dose Aspirin: Men vs Women; FDA Actions
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In this study from the University of Vermont, Turki and colleagues sought to determine the tidal volumes delivered and peak airway pressures generated during manual ventilation (hand bagging). They recruited experienced, off-duty respiratory therapists who worked regularly in the ICU and thus frequently performed manual ventilation.
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Intracerebral hemorrhage is defined as extravasation of blood into the brain parenchymal tissue or ventricles. This form of hemorrhage may be primary (as in hypertension or amyloid angiopathy) or it can be secondary to vascular lesions or coagulopathy, or trauma or tumor.
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Leonard and colleagues reviewed all the sputum specimens obtained to test for tuberculosis for nearly 4 years in a large public teaching hospital. Sensitivities of first, second, and third acid-fast bacilli (AFB) smears were calculated overall and also separately for HIV-negative and HIV-positive patients.
