Surely the NEJM could do a better review of delirium tremens

2.5 out of 5 stars Recognition and Management of Withdrawal Delirium (Delirium Tremens). Schuckit MA. N Engl J Med 2014 Nov 27;371:2109-2113. No abstract available This is an amazingly inept paper, even by the traditionally low standards of the New England Journal‘s  “Review Article” section. It was written by a psychiatrist who — on the basis of this piece — seems not to deal with severe alcohol withdrawal or delirium tremens at all. At times, the author does not appear to appreciate the serious nature of DTs and the difficulty of treating the condition adequately. For instance, he states that “treatment is best carried out in a locked inpatient ward or an ICU.” I would suggest that the thought of managing a patient with  DTs in a locked (presumably psychiatric) ward is — to use the technical term — nuts. But Dr. Schuckit is not done. Later on he writes: “The doses needed to control agitation and insomnia vary dramatically among patients and can be prodigious (e.g.,>2000 mg of diazepam in the first 2 days in some patients); this underscores the advisability of providing treatment in a hospital, preferably in an ICU.” Excuse me? It is only “advisable” to treat DTs in the hospital? I’d say it’s damned mandatory. It is just beyond me why the author does not say simply: “Patients should be treated in the ICU.” Full stop. Although the author does say t...
Source: The Poison Review - Category: Toxicology Authors: Tags: Medical alcohol withdrawal delirium tremens DTs review article Source Type: news

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Authors: Hernandez A, Nuñez JH, Sallent A, Gargallo-Margarit A, Gallardo-Calero I, Barro V Abstract Backgroud: Untreated osteonecrosis of the femoral head ultimately leads to secondary coxarthrosis. The aim of this study was to determinate if the core decompression of the femoral head combined with implantation of autologous bone marrow concentrate with tricalcium phosphate could be used to prevent radiographic progression of early stage osteonecrosis of the hip. We also sought to determine whether this treatment improved clinical outcomes and reduced the need for total hip arthroplasty. Methods: Eightee...
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Source: SafetyLit - Category: International Medicine & Public Health Tags: Age: Adolescents Source Type: news
The present study describes the development of the "Clear Picture...!? course program and examines its effectiveness. "Clear Picture...!?" is a one-day course on alcohol prevention aimed at Estonian adolescents aged 17 to 19 years and is carried out in edu...
Source: SafetyLit - Category: International Medicine & Public Health Tags: Age: Adolescents Source Type: news
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Source: TIME: Health - Category: Consumer Health News Authors: Tags: Uncategorized Drugs Source Type: news
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Source: Cliffside Malibu - Category: Addiction Authors: Tags: Addiction Addiction Recovery Alcohol Alcohol Rehab Information Alcoholism Sober Living and Aftercare healthy life Source Type: blogs
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