Current Emergency and Hospital Medicine Reports This is an RSS file. You can use it to subscribe to this data in your favourite RSS reader or to display this data on your own website or blog.

Update on Hepatitis C Screening and Management: Actions for Emergency Departments
AbstractPurpose of ReviewReview epidemiology, screening recommendations, management, and treatment of hepatitis C virus and strategies to expand diagnosis and effective linkage to care.Recent FindingsHepatitis C virus (HCV) infections have increased threefold from 2010 to 2016 and close to half of people infected remain unaware of their HCV status. Emergency departments and hospitals are points of care where health care is provided to people who often do not otherwise receive regular primary health care and recommended screening tests. Recent studies in emergency departments have shown that expanded testing can identify ma...
Source: Current Emergency and Hospital Medicine Reports - August 18, 2019 Category: Emergency Medicine Source Type: research

Zoonosis: Update on Existing and Emerging Vector-Borne Illnesses in the USA
AbstractPurpose of reviewThis review describes mosquito- and tick-borne diseases found in the Western Hemisphere. It focuses on emerging diseases and recent geographic shifts in the presence of disease vectors.Recent FindingsMosquito and tick vectors have become more widespread as environmental conditions have become more favorable. Zika recently has emerged as a concern for fetal anomalies. West Nile Virus has become widespread. Lyme disease and other tick-borne diseases are more prevalent in areas previously inhospitable to these ticks.SummaryHealthcare providers must consider the possibility of mosquito- and tick-borne ...
Source: Current Emergency and Hospital Medicine Reports - August 12, 2019 Category: Emergency Medicine Source Type: research

Peripartum Cardiomyopathy: a Review
This article conducts a review of recent literature and gives insight into this disease.Recent FindingsThere is promising research in the fields of vascular, hormonal, and genetics. A number of genetic markers are being analyzed, including TTNC1, TTN, and STAT3. Mutations to these genes have been found to be prevalent in PPCM. These combined with the secretion of placental angiogenic factors potentially create imbalance in angiogenesis as the primary etiology.SummaryCurrent biomarkers do not differentiate between PPCM and other variants of heart failure. Women with PPCM are more likely to have a cesarean section, to have h...
Source: Current Emergency and Hospital Medicine Reports - July 21, 2019 Category: Emergency Medicine Source Type: research

Thromboprophylaxis Strategies in Acute Medically Ill Patients
AbstractPurpose of ReviewWe review pivotal clinical trials of extended-duration venous thromboembolism (VTE) prophylaxis strategies in acute medically ill patients.Recent FindingsFor VTE prophylaxis in medically ill patients, current guidelines recommend the use of parenteral anticoagulants during hospitalization but not for extended duration prophylaxis. In 2017, betrixaban was approved for VTE prophylaxis in acute medically ill patients based on the results of the APEX trial. The MARINER trial missed its primary endpoint of reducing the composite of symptomatic VTE and VTE-related mortality with rivaroxaban compared with...
Source: Current Emergency and Hospital Medicine Reports - July 17, 2019 Category: Emergency Medicine Source Type: research

Systematic Review of Current Treatment and Prevention Strategies for Clostridium difficile
AbstractPurpose of ReviewThe goal of this review was to determine the current treatment and prevention recommendations forClostridium difficile infections (CDI) and their efficacy. We elucidate new treatment and prevention strategies that are in development, and define populations that are at greatest risk of CDI.Recent FindingsNew practice guidelines recommend vancomycin or fidaxomicin as first-line treatment for CDI with oral metronidazole only being used in cases of non-severe CDI when vancomycin and fidaxomicin are not available. Metronidazole is recommended in an IV formulation in conjunction with oral vancomycin in f...
Source: Current Emergency and Hospital Medicine Reports - June 26, 2019 Category: Emergency Medicine Source Type: research

Infective Endocarditis in Intravenous Drug Users —a Modern Outlook
AbstractPurpose of ReviewInfective endocarditis (IE) is a significant risk and complication in patients with a history of intravenous (IV) drug use (DU), and treatments are becoming more invasive as infections become more serious. IV drug use is an extremely addictive behavior and challenging behavior to address, and patients are at high risk of relapse to IV drug use even after successful IE treatment. Addressing the underlying cause with behavioral modification is essential to prevent behavior and subsequent infection recurrence. Treatments depend on a multidisciplinary approach to address the physiologic and underlying ...
Source: Current Emergency and Hospital Medicine Reports - June 21, 2019 Category: Emergency Medicine Source Type: research

Neonatal Sepsis
AbstractPurpose of ReviewNeonatal sepsis is a diagnosis made in infants less than 28 days of life and consists of a clinical syndrome that may include systemic signs of infection, circulatory shock, and multisystem organ failure.Recent FindingsCommonly involved bacteria includeStaphylococcus aureus andEscherichia coli. Risk factors include central venous catheter use and prolonged hospitalization. Neonates are at significant risk of delayed recognition of sepsis until more ominous clinical findings and vital sign abnormalities develop. Blood culture remains the gold standard for diagnosis.SummaryNeonatal sepsis remains an ...
Source: Current Emergency and Hospital Medicine Reports - June 18, 2019 Category: Emergency Medicine Source Type: research

Regulatory and Clinical Perspective on Biosimilars: a Comparison of the US and European Experiences
AbstractPurpose of ReviewThe purpose of the review is to explore the reasons for low penetration of biosimilars in the United States (US) and to compare and contrast the US and European experiences.Recent FindingsA biosimilar is a biologic that is highly similar to and with no clinically meaningful differences from an existing Food and Drug Administration (FDA)-approved reference product, where the reference product is the biologic that was originally approved by the FDA. The Biologics Price Competition and Innovation Act of 2009 (BPCIA) created an abbreviated approval pathway (351(k)) for biosimilars to encourage their de...
Source: Current Emergency and Hospital Medicine Reports - June 14, 2019 Category: Emergency Medicine Source Type: research

Tick-Borne Illness for Emergency Medicine Providers
AbstractPurpose of ReviewTicks are the most important vectors of human diseases after mosquitoes. Emergency physicians throughout the USA can be expected to encounter Lyme disease, Rocky Mountain spotted fever, ehrlichiosis, and other disorders based upon geographic location.Recent FindingsThe number of identifiable disorders transmitted by these arthropods has increased in recent years. Severe fever with thrombocytopenia syndrome has only been described within the past decade, and the new millennium has seen over 10 new species of rickettsial disease discovered.SummaryTicks transmit more pathogenic species than any other ...
Source: Current Emergency and Hospital Medicine Reports - June 12, 2019 Category: Emergency Medicine Source Type: research

Resistant Organisms and Their Approach to Management in Clinical and Emergency Care
AbstractPurpose of ReviewThis review describes the multi-drug-resistant pathogens that lead to the most life-threatening infections, and the current state of prevention and management strategies used in clinical and emergency care.Recent FindingsNew methods of early detection and screening, novel combination antibiotics, and adjuvant therapy with a better understanding of the mechanisms employed by multi-drug-resistant bacteria are in the forefront of this impending public health crisis.SummaryThe incidence of infections caused by multi-drug-resistant pathogens is rising. A robust and concerted international response from ...
Source: Current Emergency and Hospital Medicine Reports - May 30, 2019 Category: Emergency Medicine Source Type: research

Effects of Telemonitoring and Hemodynamic Monitoring on Mortality in Heart Failure: a Systematic Review and Meta-analysis
AbstractPurpose of ReviewTo examine the effectiveness of telemonitoring and hemodynamic monitoring devices in reducing mortality rates in heart failure. PubMed and Cochrane Library were searched to 1 May 2017 for randomized controlled trials and real-world studies investigating the effects of telemonitoring or hemodynamic monitoring on mortality in heart failure.Recent FindingsHeart failure is associated with increased mortality. Telemonitoring and hemodynamic monitoring have been shown to reduce mortality rates in some studies but not others.SummaryFifty-two and five publications on telemonitoring and hemodynamic monitori...
Source: Current Emergency and Hospital Medicine Reports - April 29, 2019 Category: Emergency Medicine Source Type: research

Complications After Heart Transplantation in Adults: an Update
AbstractPurpose of ReviewThe goal of this review article is to highlight our understanding of potential complications after heart transplantation. We aim to discuss recent advances within the field that directly impact the management of heart transplant recipients. Our target audiences include cardiologists, emergency medicine, and internal medicine providers.Recent FindingsHeart transplantation remains definitive therapy for end-stage heart failure. Complications after transplant can be divided in to post-operative, early, and late. Complications are related to the differing physiology of the denervated transplant heart a...
Source: Current Emergency and Hospital Medicine Reports - April 21, 2019 Category: Emergency Medicine Source Type: research

Cardiovascular Safety of Gabapentinoids
The objective of this manuscript is to describe the cardiovascular effects of the gabapentinoids gabapentin and pregabalin.Recent FindingsThe most frequent adverse effects of gabapentin and pregabalin affect the central nervous system, such as somnolence and fatigue. Additionally, pregabalin, and a much lesser extent, gabapentin, may adversely affect the cardiovascular system. Pregabalin induces peripheral edema and may cause or exacerbate heart failure. Pregabalin use has been associated with QTc prolongation in patients taking other QTc –prolonging agents, although the relative contributions of pregabalin to QTc prolon...
Source: Current Emergency and Hospital Medicine Reports - April 16, 2019 Category: Emergency Medicine Source Type: research

Ketamine for Acute Agitation
AbstractPurpose of ReviewThis review describes the use of ketamine for acutely agitated patients in the emergency care setting. Evidence for its efficacy will be reviewed and practical suggestions for using ketamine in this scenario will be presented.Recent FindingsThe available observational literature on the topic of ketamine for agitation was recently summarized in a systematic review. This review found that ketamine effectively and quickly sedates acutely agitated patients. However, it did raise some concerns about an increased intubation rate in patients administered ketamine.SummaryIn severely agitated patients, part...
Source: Current Emergency and Hospital Medicine Reports - February 6, 2019 Category: Emergency Medicine Source Type: research

Cannabinoid Hyperemesis Syndrome
AbstractPurpose of ReviewThis review describes the clinical presentation and treatment for cannabinoid hyperemesis syndrome (CHS). Typical treatment for nausea, vomiting, and abdominal pain may not be effective in patients with CHS. Alternative treatments have been suggested.Recent FindingsThe pathophysiology of CHS may be due to dysregulation of the endocannabinoid system. Two cannabinoid receptors (CB1, CB2) have been identified. Theories proposed to explain CHS including chronic stimulation of the CB1 receptor, binding of the CB1 receptor causing decreased gut motility, desensitization of CB1 receptors (these CB1 recept...
Source: Current Emergency and Hospital Medicine Reports - February 4, 2019 Category: Emergency Medicine Source Type: research