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Physicians increasingly are aware of the need to provide prophylaxis against venous thrombosis for the medically ill patient in the hospital environment. This article attempts to separate the fact from fiction regarding VTE prophylaxis.
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Merck announced on September 30th that it is voluntarily withdrawing rofecoxib (Vioxx) from the worldwide market.
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Part II of this two-part series focuses on facial nerve palsies and oropharyngeal infections. The authors present a systematic approach to differential diagnosis and identification of etiologic agents responsible for such conditions as peritonsillar abscess, epiglottitis, and pharyngeal infections. Radiographic and bacteriologic findings are emphasized, and appropriate antibiotic therapy is presented. The authors have provided treatment tables that direct emergency practitioners toward outcome-effective therapy.
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Parts I and II of this series discussed general facial wound repair, forehead and scalp trauma, eye trauma, nasal trauma, and midface fractures. This third and final part of the series covers mandible, mouth, ear, and pediatric trauma.
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This meta-analysis of clinical trials of steroids in septic shock demonstrates that whereas short-term, high-dose administration actually worsens survival, giving lower doses for a longer period hastens shock resolution and improves survival.
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Ventilator-associated pneumonia (vap) is nosocomial pneumonia occurring in a mechanically ventilated patient > 48 hours after intubation. It is categorized as early-onset (defined by most experts as 48-96 hours after intubation) and late-onset (> 2-96 hours after intubation): these differ with respect to responsible bacterial agents as well as outcomes. With an estimated incidence of 8-28% of intensive care unit (ICU) patients, or 13-35 cases per 1000 ventilator-days, VAP is common.