Internal Medicine
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Malaria: Getting Better, but Still a Long Way To Go
While significant progress has been made in the control of malaria, the number of cases remains huge — an estimated 198 million cases and 584,000 deaths in 2013.
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Antibiotic Therapy for Pediatric Parapneumonic Empyema
In a retrospective review of 391 children with parapneumonic empyema, the safety and effectiveness of oral antibiotic therapy was comparable to outpatient parenteral antibiotic therapy for antibiotic management following hospitalization.
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Encephalitis from Chikungunya Virus: An Increasingly Recognized Syndrome
A retrospective cohort study of a major chikungunya virus outbreak found a significant incidence of central nervous system disease, with patients < 1 year of age and > 65 years of age at most risk for chikungunya virus-associated encephalitis.
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Differences Between Older and Younger Adults with Viral Respiratory Infections
A prospective study of acute respiratory illness was conducted between 2009 and 2013. Coronavirus and rhinovirus/enterovirus were the most common viral pathogens. Among patients older than age 60 with chronic lung and heart disease (vs healthy adults 18-40 years old), dyspnea, more prolonged illness, and treatment with prednisone and antibiotics were more commonly seen. Myalgia was more common in younger patients.
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Azithromycin to Prevent Asthma Exacerbations?
Azithromycin helped prevent progression from upper airway infection to wheezing in a select group of preschool-age children. Further studies are needed before considering widespread use of azithromycin for young children with “colds.”
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Hospital-acquired Infections and Other Hospital-acquired Conditions — How Are We Doing?
There was a large decrease in the number of total hospital-acquired conditions from 2010-2014, but with no improvement from 2013-2014. While there were decreases in hospital-acquired infections, much further improvement is needed.
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Echo Diagnosis of Left Ventricular Non-compaction
The echocardiographic diagnosis of left ventricular non-compaction is difficult, and experienced readers disagree frequently. Careful attention to suggested criteria and the use of other imaging modalities in difficult cases resolves most diagnostic disagreements.
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FAME Data Shows Durability of Fractional Flow Reserve Strategy at 5 Years
The 5-year results of the FAME study did not show any late catch up in major adverse cardiac events in the fractional flow reserve-guided group, supporting the long-term safety of the fractional flow reserve-guided approach to percutaneous coronary interventions.
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Management of Functional Mitral Regurgitation
In symptomatic patients with coronary artery disease, left ventricular ejection fraction < 30%, and significant mitral valve regurgitation, coronary bypass graft surgery (CABG) or CABG plus mitral valve repair should be considered.
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Remote Hemodynamic Monitoring Shows Long-term Benefit in Heart Failure Patients
Remote pulmonary artery pressure monitoring in New York Heart Association class III heart failure patients resulted in fewer subsequent hospitalizations and was well tolerated.