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Intravenous thrombolysis is safe and effective for the treatment of ischemic stroke in the time window of 3-4.5 hours after the onset of symptoms.
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The incidence of legionellosis in the United States increased significantly in 2003-2005 compared to previous years. This was due mostly to an upsurge of cases in the northeastern and southern United States and a shift of disease from elderly to middle-aged adults. Legionellosis should be considered as a potential cause of pneumonia in a broad range of patients, rather than a small subset with specific risk factors.
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Many physicians have followed the historical practice of ordering blood cultures to be drawn as close as possible to the time of the peak of the febrile episode (fever spike). In the absence of prescient knowledge of this moment, physicians order blood cultures to be drawn at intervals ranging from 30 minutes to 2 hours. A paper by Jaimes et al suggested that many factors, other than fever, such as shaking chills, WBC counts, hypotension, and more were needed to better predict whether a patient was experiencing bacteremia.
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This study showed that intra-abdominal hypertension is associated with increased organ dysfunction and higher ICU mortality, and two commonly used methods for measuring intra-abdominal pressure have equivalent predictive capabilities.
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In a prospective study of immunocompetent patients admitted to critical care units, CMV viremia showed a significant association with prolonged ICU stay and death.
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Perhaps the most prominent cardiovascular report in 2007 was the publication of the COURAGE trial (N Engl J Med. 2007;356:1503-1516), which demonstrated the equality in major CV outcomes in randomized patients with stable CAD, most with angina, who were assigned PCI with optimal medical therapy (OMT) vs OMT alone, with a mean follow-up of 4.6 years.
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A randomized, controlled trial in the Netherlands showed that oral prednisolone and naproxen were equivalent in the treatment of acute gout with no difference in side effects.
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The Babinski sign continues to be a valid bed-side test for pyramidal tract lesions.
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Increased migraine attack frequency and overuse of acute medication, especially barbiturates and opiates, are risk factors for the chronification of migraine, which occurs in up to 2% of individuals.
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Although anemia was predictive of adverse outcomes in patients with aneurysmal subarachnoid hemorrhage, red blood cell transfusion was also associated with an increased risk of death, severe disability or delayed infarction. These results call into question the practice of liberal transfusion thresholds in patients with spontaneous subarachnoid hemorrhage.
