Internal Medicine
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Outbreaks of Salmonellosis Associated with Turtles
Eight outbreaks with 473 cases of salmonellosis associated with small turtles occurred in the United States from 2011-2013, despite the 1975 ban of the sale and distribution of small pet turtles. The outbreaks disproportionately affected children younger than 5 years of age (55% of case-patients) and Hispanics (45% of case-patients).
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Both Azithromycin and Doxycycline Achieve a High Rate of Cure for Chlamydia
Although a well-conducted randomized clinical trial did not show that azithromycin was non-inferior to doxycycline for the treatment of chlamydia, both treatments resulted in a high rate of cure (97% and 100%, respectively).
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Next-generation Sequencing to Diagnose Cryptic Hep B and E
ABSTRACT & COMMENTARY: Sera from patients with hepatitis of unknown etiology were studied using next-generation sequencing.
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Delay in Performing Endovascular Reperfusion Results in Worse Disability Outcomes
In the past year, multiple clinical trials have reported that intra-arterial endovascular reperfusion with mechanical clot extraction, using the SOLITAIRE stent retriever device and others, results in better neurological outcomes than treating patients with intravenous thrombolysis alone with TPA. There is still uncertainty regarding the maximum time window, and how important early intervention is as related to neurological recovery and long-term outcomes.
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Spironolactone for Resistant Hypertension
Resistant hypertension is common, and the choice of additional drug therapy in this condition is not clear.
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Clinicians Are Skeptical of Early Warning Systems for Sepsis
Severe sepsis is very common, with high morbidity and mortality. Early recognition and intervention improves mortality. However, the diagnosis may often be missed in early sepsis. An academic health system developed an electronic early warning and response system for sepsis in 2012, monitoring real time vital signs and laboratory data for hospitalized, non-ICU, acute care patients and notifying clinicians when specific criteria were met. -
Bedside Ultrasound: Is It a Reliable Tool for Guiding Resuscitation in Patients with Undifferentiated Hypotension?
The use of bedside ultrasound has expanded tremendously over the last few decades. As it is readily available and relatively inexpensive, ultrasound provides the opportunity to examine hypotensive, critically ill patients, potentially leading to a faster, more accurate diagnosis.
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Sepsis Resuscitation and Mortality
The use of balanced salt solutions rather than isotonic saline or colloids may improve in-hospital mortality in patients admitted with septic shock.
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Prescient Warning Symptoms: A New Target for Sudden Cardiac Death Prevention
Typical cardiac symptoms frequently precede sudden cardiac arrest and are frequently unheeded, but when acted on are associated with decreased mortality.
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Five-year EVEREST II Results Allay Long-term Safety and Durability Concerns About MitraClip
Although MitraClip patients had higher rates of re-operation in the first year, adverse event rates in the 1- to 5-year range were reassuringly low and were comparable with surgery.