The "Oregon Experiment" at 2 Years
General Medicine
Summary and Comment
Free
A lottery for Medicaid enrollment simulates a randomized trial.
By Allan S. Brett, MD
May 9, 2013
Covering:
Baicker K et al., N Engl J Med 2013 May 2; 368:1713
Another Look at the "Ampicillin Rash"
This study found a lower incidence of antibiotic-associated rash in children with Epstein-Barr virus acute infectious mononucleosis than previously reported.
By Deborah Lehman, MD
May 1, 2013
Covering:
Chovel-Sella A et al., Pediatrics 2013 May 1; 131:e1424
FDA Lowers Age Restriction on Plan B One-Step
Women's Health
News in Context
Decision makes EC available without prescription (but with proof of age) to women aged 15 and older.
Letter to Readers
In the shadow of the Boston marathon violence, here is some advice you can share with parents on how to help their children cope.
Subclinical Atrial Fibrillation Is Common in Patients with Cryptogenic Stroke
Neurology
Summary and Comment
An implantable loop recorder established new diagnoses of atrial fibrillation in 25% of patients with cryptogenic stroke.
By Hooman Kamel, MD
April 30, 2013
Covering:
Cotter PE et al., Neurology 2013 Apr 23; 80:1546
Novel Avian-Origin Influenza A (H7N9) Virus in China
Infectious Diseases
Summary and Comment
Free
Testing of throat-swab specimens from three patients who died of severe lower respiratory tract disease revealed infection with a novel reassortant H7N9 virus.
FDA Approves New Pooled Plasma Product to Reverse Anticoagulation
The FDA has approved a new product, derived from pooled plasma, to reverse vitamin K antagonist (e.g., warfarin) anticoagulation in adults with major bleeding.
Approval...
FDA Lowers Age Restriction on Plan B One-Step to 15 and Older
The FDA has approved an application to market Plan B One-Step (levonorgestrel) emergency contraceptive for use without prescription to women aged 15 and older...
Opening Up Emergency Contraception
Women's Health
News in Context
Free
Court ruling would lift age restrictions on over-the-counter access.
Best Options in Emergency Contraception
Access is broadened by judge's order to make levonorgestrel-containing EC pills nonprescription regardless of a woman's age.
Inherited Risks for Venous and Arterial Thromboembolism
Non-O blood type, factor V Leiden mutation, and prothrombin mutation were risk factors in a study of the Danish general population.
Immunological Parameters Associated with Sepsis Outcome
Infectious Diseases
Summary and Comment
Impaired in vitro response to lipopolysaccharide during the early phase of sepsis and — in older patients — prolonged lymphopenia with loss of immunocompetent T cells were identified as mortality predictors.
By Thomas Glück, MD
April 10, 2013
Covering:
Kiguchi T et al., Crit Care Med 2013 Mar 7
Inoue S et al., Crit Care Med 2013 Mar; 41:810
Updated Guidelines for the Prevention and Control of Meningococcal Disease
Infectious Diseases
Clinical Practice Guideline Watch
These guidelines compile and summarize the CDC's recommendations, first published in 2005, and the changes made since then.
By Stephen G. Baum, MD
April 17, 2013
Covering:
Centers for Disease Control and Prevention (CDC)., MMWR Recomm Rep 2013 Mar 22; 62:1
Driving to Distraction: A Serious Problem
Psychiatry
Summary and Comment
Can physician behavior influence patients?
By Jonathan Silver, MD
April 8, 2013
Covering:
Centers for Disease Control and Prevention (CDC)., MMWR Morb Mortal Wkly Rep 2013 Mar 15; 62:177
Exercise as Treatment for Postconcussive Symptoms
Psychiatry
Summary and Comment
Free
Progressive aerobic exercise results in imaging changes and symptomatic improvement — at least for relatively uncomplicated concussions.
By Jonathan Silver, MD
April 8, 2013
Covering:
Leddy JJ et al., J Head Trauma Rehabil 2012 Dec 15
Gastrointestinal Complications from NSAID Use in Clinical Practice
Gastroenterology
Summary and Comment
Free
In a PROBE trial of 8067 patients with osteoarthritis, 1.3% using celecoxib experienced GI complications compared with 2.4% using a nonselective NSAID.
Coccidioidomycosis on the Rise
Infectious Diseases
Summary and Comment
Free
Incidence of this endemic fungal disease increased eight-fold between 1995 and 2011.
By Stephen G. Baum, MD
April 3, 2013
Covering:
Centers for Disease Control and Prevention (CDC)., MMWR Morb Moral Wkly Rep 2013 Mar 29
Ultrasound Guidance Significantly Lowers Risk for Failed Lumbar Punctures and Epidural Catheterizations
General Medicine
Summary and Comment
The failure rate was 1% with ultrasound and 7% with standard palpation of landmarks.
Bringing New Meaning to the Term "Emergency Contraception"
Women's Health
Summary and Comment
Free
Disruption of contraceptive access is common during emergency response situations.
Addressing the "Revolving Door" of Readmissions
Hospital Medicine
Summary and Comment
Three studies provide a closer look at the 30-day readmission rate as a quality measure and show unintended consequences.
By Jennifer E. Bracey, MD, and Neil H. Winawer, MD, SFHM
March 25, 2013
Covering:
Vashi AA et al., JAMA 2013 Jan 23; 309:364
Dharmarajan K et al., JAMA 2013 Jan 23; 309:355
Brock J et al., JAMA 2013 Jan 23; 309:381
Williams MV., JAMA 2013 Jan 23; 309:394
The Diagnosis and Management of Acute Otitis Media
Infectious Diseases
Clinical Practice Guideline Watch
This revised, evidence-based guideline for managing uncomplicated acute otitis media in children aged 6 months through 12 years strengthens the wait-and-see option and increases the emphasis on prevention.
Influenza Can Sneak Past Surgical Masks
General Medicine
Summary and Comment
Air samples yielded small-particle viral RNA as far as 6 feet from infected patients.
By Abigail Zuger, MD
April 9, 2013
Covering:
Bischoff WE et al., J Infect Dis 2013 Apr 1; 207:1037
Hall CB., J Infect Dis 2013 Apr 1; 207:1027
Does Clarithromycin Use Lead to CV Events?
General Medicine
Summary and Comment
In patients with COPD or pneumonia, clarithromycin was associated with prolonged excess risk for adverse cardiovascular events.
Updated Expert Guidelines on Risks for and Management of Sports Concussion
General Medicine
Clinical Practice Guideline Watch
Free
No known treatment speeds recovery or postconcussion impairment; monitoring to full recovery is critical.
What Is the True Incidence of Severe Sepsis in the U.S.?
Infectious Diseases
Summary and Comment
Free
Estimates for 2004 though 2009 varied from 300 to >1000 cases per 100,000 population annually, depending on the definitions and ICD codes used.
By Thomas Glück, MD
March 27, 2013
Covering:
Gaieski DF et al., Crit Care Med 2013 Mar 15