Internal Medicine
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Stroke: Rehabilitation and Recovery
Rehabilitation is a critical component of stroke treatment, as most stroke survivors are left with significant neurological impairments and other sequelae, such as spasticity and pain. Stroke rehabilitation aims to reverse these impairments to the extent possible, maximize functionality through the use of compensatory approaches, prevent complications, and manage comorbidities. This article reviews the basic principles of rehabilitation, current practices, and evidence supporting various aspects of stroke rehabilitation.
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Infectious Disease Alert Updates
Antibiotic increases honeybee mortality; Sustained hepegivirus infection in injection drug users; Decrease SSIs: Take August off
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2016 Surviving Sepsis Guidelines Update
The Surviving Sepsis Campaign recently published an update to the 2012 guidelines for management of sepsis and septic shock. The document incorporates literature published through July 2016.
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Sepsis Management: What We Think We Know
In the Protocolized Resuscitation in Sepsis Meta-Analysis (PRISM), 3,723 patients’ outcomes from the ProCESS, ARISE, and ProMISe randomized, controlled trials of early goal-directed therapy (EGDT) were evaluated. EGDT did not result in better outcomes than usual care and was associated with higher costs. The authors of a second study looked at outcomes of 49,331 patients with sepsis treated in New York from April 2014 to June 2016. More rapid completion of the three-hour sepsis bundle and antibiotic administration (but not rapid bolus administration of IV fluids) was associated with reduced in-hospital mortality.
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Bug Bytes From Barcelona: Report of the 15th Conference of the International Society of Travel Medicine
In addition to issues of malaria, vaccination, and trauma in travelers, viral diseases and the management of diarrhea were key topics at the biannual meeting of the International Society of Travel Medicine in Barcelona, Spain, during May 2017.
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Not Just Ebola — Lassa Fever Rears its Ugly Head Once Again
Outbreaks of Lassa fever are occurring in Nigeria and several other West African nations, some of which also are endemic for Ebola virus infections.
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Dual Antibiotic Therapy Is Not Routinely Necessary for Uncomplicated Cellulitis
A randomized, multicenter, placebo-controlled clinical trial that enrolled patients presenting to emergency departments with uncomplicated cellulitis found the addition of trimethoprim-sulfamethoxazole to cephalexin did not lead to better outcomes.
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Cognitive Behavioral Therapy for Chronic Low Back Pain
Low back pain and functional limitation scores in adults with chronic low back pain improved among those randomly assigned to receive either cognitive behavioral therapy or mindfulness-based stress reduction interventions when compared to usual care.
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Alzheimer’s Prevention: No Harm in ‘Forgetting’ Vitamin E and/or Selenium
This large-scale study of asymptomatic elderly men reveals no indication that selenium or vitamin E (taken alone or in combination) prevents development of dementia.
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Bergamot Shows Potential as an Alternative to Statins for Hyperlipidemia
Although larger controlled studies are warranted, bergamot supplementation may be an alternative approach to improving cardiovascular risk in patients who are unable or unwilling to take pharmaceutical HMG-CoA reductase or PCSK9 inhibitors.