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Most cases of thrombocytopenia seen are expected. Patients are known to have hematological disease or are receiving chemotherapy. At times, however, the physician is confronted with an unexpected laboratory finding in an asymptomatic patient, or with a patient who is bleeding. The challenge, as usual, is to determine the need for acute treatment and the appropriate disposition.
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Stop smoking drug Chantix rates stronger warning from FDA; Type 2 diabetes surgery on the way?; Vytorin study inconclusive; Influenza A virus found resistant to Tamiflu; FDA actions.
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Using a simple clinical screening tool, patients considered at high risk for death in this closed medical ICU received a basic palliative care consultation. Those with unmet needs received a full consultation with ongoing intervention from the palliative care team. This process shortened ICU length of stay without affecting mortality rates or discharge disposition.
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Two recent studies suggest that rapid TIA evaluation and treatment can reduce stroke risk.
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Schistosomiasis and strongyloidiasis were highly prevalent in two cohorts of African refugees resettled to the United States; presumptive treatment for parasitic diseases in such groups should include coverage for these parasitoses.
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Of 2761 patients with endocarditis enrolled in a prospective, multinational cohort study, 49 patients with non-HACEK gram-negative endocarditis were identified. E. coli and Pseudomonas aeruginosa were the most common pathogens, and 57% were considered to be health care associated. Fifty-nine percent of cases were associated with prosthetic valves. The mortality rate was high (24%) despite cardiac surgery being performed in 51% of cases.
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An early invasive approach is preferred for higher risk non-ST elevation acute coronary syndromes (NSTE-ACS), but the optimal timing of cardiac catheterization is not clear.
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