Epidural Steroids, Etanercept, or Saline Injections for Subacute Sciatica?
General Medicine Summary and Comment
No significant benefit was found for drug treatment relative to saline.
What's the Incidence of Venous Thromboembolism After Knee Arthroscopy?
General Medicine Summary and Comment
Incidence was 0.40% in this large cohort study.
By Allan S. Brett, MD
April 24, 2012
Covering:
Maletis GB et al., J Bone Joint Surg Am 2012 Apr 18; 94:714
Anticoagulation for Pregnant Women with Mechanical Prosthetic Heart Valves
Women's Health Summary and Comment
Encouraging results with low-dose warfarin throughout pregnancy, but the approach must be validated.
By Kirsten E. Fleischmann, MD, MPH
April 19, 2012
Covering:
De Santo LS et al., J Am Coll Cardiol 2012 Mar 20; 59:1110
Elkayam U and Goland S., J Am Coll Cardiol 2012 Mar 20; 59:1116
Infective Endocarditis Involving Implantable Cardiac Devices
Infectious Diseases Summary and Comment
Free
Both in-hospital and 1-year mortality rates were high in this multinational survey.
Metformin Plus Insulin vs. Insulin Alone in Patients with Type 2 Diabetes
General Medicine Summary and Comment
Free
Combination therapy led to lower insulin doses and better glycemic control.
How Risk Factors for SIDS Have Changed Since the Back-to-Sleep Campaign
A higher percentage of cases are now associated with side sleep position and bed-sharing, and prone position still accounts for 30% of cases.
Combination Therapy for Chronic Migraine
Neurology Summary and Comment
Adding propranolol to topiramate is unlikely to provide a clinically relevant benefit to patients who have inadequate relief on topiramate monotherapy.
By Koen Paemeleire, MD, PhD
April 24, 2012
Covering:
Silberstein SD et al., Neurology 2012 Mar 27; 78:976
Measles in the U.S.: 2011 Was a Bad Year
Infectious Diseases Summary and Comment
Most cases occurred in unvaccinated individuals and were associated with importations from abroad.
By Stephen G. Baum, MD
April 25, 2012
Covering:
Centers for Disease Control and Prevention (CDC)., MMWR Morb Mortal Wkly Rep 2012 Apr 20; 61:253
Can You Diagnose Strep Throat Without a Culture?
Infectious Diseases Summary and Comment
Compared with culture or rapid diagnostic tests, clinical criteria for diagnosing streptococcal pharyngitis are not sufficiently specific.
Can Bad Medical News Be Fatal?
Psychiatry Summary and Comment
Free
Patients receiving a cancer diagnosis, especially one with poor prognosis, are at high risk for suicide or for cardiovascular death in the week following the diagnosis, and even up to a year later.
By Peter Roy-Byrne, MD
April 4, 2012
Covering:
Fang F et al., N Engl J Med 2012 Apr 5; 366:1310
Treatment of Acute Bacterial Rhinosinusitis in Children and Adults
Infectious Diseases Clinical Practice Guideline Watch
The guideline includes a management algorithm, with recommendations for treating patients who do not respond to initial empirical therapy.
By Stephen G. Baum, MD
April 4, 2012
Covering:
Chow AW et al., Clin Infect Dis 2012 Apr 15; 54:1041
Heavy Backpacks Are Associated with Back Pain in Teens
Risk for back pain was 50% higher among those with the heaviest versus lightest backpacks.
Dexmedetomidine for Sedation of Mechanically Ventilated ICU Patients
Hospital Medicine Summary and Comment
In two multicenter randomized controlled trials, dexmedetomidine compared favorably with midazolam and propofol.
Graduate Medical Education's Next Accreditation System
Hospital Medicine Summary and Comment
Specialty accreditation for residency training focuses on milestones, educational outcomes, and public accountability.
Fecal Transplantation Effective for C. difficile Infection
Gastroenterology Summary and Comment
In the largest case series to date, fecal transplantation was associated with a 94% cure rate.
By Douglas K. Rex, MD
March 30, 2012
Covering:
Mattila E et al., Gastroenterology 2012 Mar; 142:490
Rifaximin Efficacious in Moderately Active Crohn Disease
Gastroenterology Summary and Comment
Free
Twelve weeks of extended-release rifaximin at 800 mg twice daily induced remission in 62% of patients and was both safe and well tolerated.
By Douglas K. Rex, MD
March 30, 2012
Covering:
Prantera C et al., Gastroenterology 2012 Mar; 142:473
Treating Community-Acquired Pneumonia in Kids: How Guideline Implementation Affects Practice
Use of broad-spectrum antibiotics declined after implementation of guidelines for treating children hospitalized with uncomplicated CAP.
Is Oral Antibiotic Therapy Enough for Children with Acute Pyelonephritis?
A randomized trial failed to prove the noninferiority of oral antibiotic monotherapy, relative to sequential intravenous and oral therapy, but evidence supporting oral treatment alone as an option is accumulating.
By Louis M. Bell, MD
March 21, 2012
Covering:
Bocquet N et al., Pediatrics 2012 Feb; 129:e269
Linezolid Outperforms Vancomycin for Nosocomial MRSA Pneumonia
Infectious Diseases Summary and Comment
The clinical cure rate was significantly higher with linezolid than with vancomycin; mortality and serious adverse event rates were similar between the drugs.
By Neil M. Ampel, MD
March 21, 2012
Covering:
Wunderink RG et al., Clin Infect Dis 2012 Mar 1; 54:621
Torres A., Clin Infect Dis 2012 Mar 1; 54:630
Represcribing High-Risk Drugs After Acute Upper Gastrointestinal Bleeding
Gastroenterology Summary and Comment
Within 1 year after a bleeding episode, many patients were again receiving the potentially causative drug — but often with a proton-pump inhibitor.
Topical Antibiotics for Clean Dermatologic Procedures
Dermatology Summary and Comment
Less-frequent use is a step in the right direction.
By Jan V. Hirschmann, MD
March 23, 2012
Covering:
Levender MM et al., J Am Acad Dermatol 2012 Mar; 66:445
Low Risk for Febrile Seizure After DTaP-IPV-Hib Vaccination
In a population-based study from Denmark, risk for epilepsy was not increased, but a small increased risk for febrile seizures was observed on the day of the first and second vaccine doses.
Pasteurella Infections — Not Only from Animal Bites
General Medicine Summary and Comment
Sick pets may transmit upper respiratory infection.
By Abigail Zuger, MD
March 20, 2012
Covering:
Myers EM et al., Clin Infect Dis 2012 Mar 15; 54:e55
Antidepressants Work, and Depression Severity Does Not Matter
Psychiatry Summary and Comment
Free
Effects are greatest in children, but are significant for all, in a study examining patient-level data from 41 studies focusing on two antidepressants.
By Peter Roy-Byrne, MD
March 12, 2012
Covering:
Gibbons RD et al., Arch Gen Psychiatry 2012 March 5
Highly Azithromycin-Resistant Gonococcus Identified in the U.S.
Infectious Diseases Summary and Comment
This discovery bodes ill for treatment of gonorrhea.
By Stephen G. Baum, MD
March 7, 2012
Covering:
Katz AR et al., Clin Infect Dis 2012 Mar 15; 54:841
