The value of controversy in medicine – sepsis
Conclusion:
No high- or moderate-level evidence shows that SEP-1 or its hemodynamic interventions improve survival in adults with sepsis.
We must hope that this controversy will lead to gathering more information to resolve the controversies and improve care. Science demands controversy. Medicine demands that we view everything critically. My opinions on the controversy are not as important as exposing the controversy. (Source: DB's Medical Rants)
Source: DB's Medical Rants - May 4, 2018 Category: Internal Medicine Authors: rcentor Tags: Medical Rants Source Type: blogs
LITFL Review 323
LITFL • Life in the Fast Lane Medical Blog LITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog
Welcome to the 323rd LITFL Review! Your regular and reliable source for the highest highlights, sneakiest sneak peeks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the blogosphere’s best and brightest and deliver a bite-sized chunk of FOAM.
The Most Fair Dinkum Ripper Beauts of the Week
Are you still ordering BNPs? Spiegel and Morgenstern do a deep dive into the literature to he...
Source: Life in the Fast Lane - March 18, 2018 Category: Emergency Medicine Authors: Marjorie Lazoff, MD Tags: Education LITFL review Source Type: blogs
Knee mottling reflects regional endothelial dysfunction and a worse prognosis in septic shock
(Source: Notes from Dr. RW)
Source: Notes from Dr. RW - February 6, 2018 Category: Internal Medicine Tags: critical care Source Type: blogs
LITFL Review 317
LITFL • Life in the Fast Lane Medical Blog
LITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog
Welcome to the 317th LITFL Review! Your regular and reliable source for the highest highlights, sneakiest sneak peeks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the blogosphere’s best and brightest and deliver a bite-sized chunk of FOAM.
The Most Fair Dinkum Ripper Beauts of the Week
Learn to be a pediatric airway master with these fundamental moves from PEM Playbook. [MMS]
T...
Source: Life in the Fast Lane - February 4, 2018 Category: Emergency Medicine Authors: Marjorie Lazoff, MD Tags: LITFL review Source Type: blogs
To Err is Homicide in Britain – the case of Dr. Hadiza Bawa-Garba
By, SAURABH JHA
The good that doctors do is oft interred by a single error. The case of Dr. Hadiza Bawa-Garba, a trainee pediatrician in the NHS, convicted for homicide for the death of a child from sepsis, and hounded by the General Medical Council, is every junior doctor’s primal fear.
An atypical Friday
Though far from usual, Friday February 18th, 2011 was not a typically unusual day in a British hospital. Dr. Bawa-Garba had just returned from a thirteen-month maternity break. She was the on-call pediatric registrar – the second in command for the care of sick children at Leicester Royal Infirmary. As a “r...
Source: The Health Care Blog - January 30, 2018 Category: Consumer Health News Authors: at RogueRad Tags: Patients Physicians The Business of Health Care Source Type: blogs
LITFL Review 316
LITFL • Life in the Fast Lane Medical Blog
LITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog
Welcome to the 316th LITFL Review! Your regular and reliable source for the highest highlights, sneakiest sneak peeks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the blogosphere’s best and brightest and deliver a bite-sized chunk of FOAM.
The Most Fair Dinkum Ripper Beauts of the Week
Ercast’s Rob Orman from sits down with performance coach Jason Brooks to discuss performanc...
Source: Life in the Fast Lane - January 28, 2018 Category: Emergency Medicine Authors: Marjorie Lazoff, MD Tags: Education LITFL review Source Type: blogs
Hospital Groups Plan to Launch a Company to Manufacture Generic Drugs
Manufacturers of generic drugs likeTeva Pharmaceutical have been suffering serious financial reverses (see: Teva warns on profit as drugmaker's problems deepen). Moreover, periodic shortages of generic drugs have been exacerbated by the fact that some of them are manufactured by only one company (see:New Study Highlights Escalated Dangers of Generic Drug Shortages). Here is a quote from this article:In 2011, 251 drug shortages occurred, 73% of which were generic sterile injectables that served as treatments for sepsis, cancer, and other life-threatening illnesses. In February 2011, the FDA announced a severe nati...
Source: Lab Soft News - January 27, 2018 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Food and Drug Administration Healthcare Business Healthcare Innovations Hospital Executive Management Pharmaceutical Industry Quality of Care Source Type: blogs
LITFL Review 315
LITFL • Life in the Fast Lane Medical Blog
LITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog
Welcome to the 315th LITFL Review! Your regular and reliable source for the highest highlights, sneakiest sneak peeks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the blogosphere’s best and brightest and deliver a bite-sized chunk of FOAM.
The Most Fair Dinkum Ripper Beauts of the Week
Rob Macsweeney of Critical Care Reviews posts the 2 hour livestream of the ADRENAL Trial as ...
Source: Life in the Fast Lane - January 21, 2018 Category: Emergency Medicine Authors: Marjorie Lazoff, MD Tags: Education LITFL review Source Type: blogs
Try to avoid vancomycin/pip-tazo
This study used a retrospective matched cohort technique – not a randomized controlled trial, but a reasonable methodology.
Patients in both VC and VPT groups had similar baseline characteristics in terms of age, length of ICU stay, Charlson comorbidity index score, baseline creatinine, and use of concomitant nephrotoxins.
The groups had great similarity.
The rate of AKI was higher among patients receiving VPT compared to those receiving VC combination therapy. Based on RIFLE criteria, 81 patients in the VPT group developed AKI compared to 31 patients in the VC group (29.0% vs 11.1%; hazard ratio [HR] = 4.0; 95% conf...
Source: DB's Medical Rants - January 8, 2018 Category: Internal Medicine Authors: rcentor Tags: Medical Rants Source Type: blogs
Research and Reviews in the Fastlane 190
LITFL • Life in the Fast Lane Medical Blog
LITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog
Welcome to the 190th edition of Research and Reviews in the Fastlane. R&R in the Fastlane is a free resource that harnesses the power of social media to allow some of the best and brightest emergency medicine and critical care clinicians from all over the world tell us what they think is worth reading from the published literature.
This edition contains 5 recommended reads. The R&R Editorial Team includes Jeremy Fried, Nudrat Rashid, Justin Morgenstern and Chris...
Source: Life in the Fast Lane - January 3, 2018 Category: Emergency Medicine Authors: Justin Morgenstern Tags: Emergency Medicine Gastroenterology Infectious Disease R&R in the FASTLANE Resuscitation EBM Education recommendations research and reviews Source Type: blogs
I ’ll never understand why some patients end up as percentages
Monday
I walk into your room in the pediatric intensive care unit as two nurses are repositioning you. Your parents stand nearby — your dad in his frayed baseball cap and khaki cargo shorts. Your mom in baggy jeans wrinkled with the same worry as the lines near her eyes. Your little sister sits near the window with a blue hospital mask over her mouth and hugging her knees. Grandma sits snug beside her with her back straight and hair done, expression cordial.
You are a fifteen-year-old boy with leukemia who came into our emergency department last week with fevers but spiraled quickly into septic shock with multiple organ ...
Source: Kevin, M.D. - Medical Weblog - December 19, 2017 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/evelyn-lai" rel="tag" > Evelyn Lai, CRNP < /a > Tags: Physician Critical Care Pediatrics Source Type: blogs
The IDSA takes an admirable position in not endorsing the new Sepsis Guidelines
This article explains wonderfully the problem of guidelines. Confirmation bias will impact all guideline panel members. As you read the IDSA explanations, you can see that they have focused on the unintended consequences of markedly increasing sensitivity and therefore markedly decreasing specificity. The reference for the IDSA article (abstract only unless you have access).
The main points are found in the report – IDSA withholds support for international sepsis guidelines
The IDSA’s major concern with the guidelines is that they fail to recognize the “practical difficulties” in diagnosing sepsis. The ...
Source: DB's Medical Rants - December 18, 2017 Category: Internal Medicine Authors: rcentor Tags: Medical Rants Source Type: blogs
Having an ID doc involved in the ER management of severe sepsis and septic shock
(Source: Notes from Dr. RW)
Source: Notes from Dr. RW - December 7, 2017 Category: Internal Medicine Tags: critical care Source Type: blogs
Fight Aging! Newsletter, November 20th 2017
This study cohort is a healthy subset of the EpiPath cohort, excluding all participants with acute or chronic diseases. With a mediation analysis we examined whether CMV titers may account for immunosenescence observed in ELA.
In this study, we have shown that ELA is associated with higher levels of T cell senescence in healthy participants. Not only did we find a higher number of senescent cells (CD57+), these cells also expressed higher levels of CD57, a cell surface marker for senescence, and were more cytotoxic in ELA compared to controls. Control participants with high CMV titers showed a higher number of senes...
Source: Fight Aging! - November 19, 2017 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs
Why is Sepsis a Condition of the Elderly?
Sepsis and consequent septic shock occur more frequently in the old and cause greater harm and mortality in older individuals. The condition occurs when an infection spurs the immune system into a state of runaway inflammation and then shutdown, sufficient to disrupt or permanently damage metabolism and organ function. The open access paper here dives into the details of age-related immune system dysfunction, with an eye to explaining why exactly these failures cause sepsis to be both worse and more prevalent in the elderly. As for so many of the specific frailties of old age, the best solution is to repair the immune syst...
Source: Fight Aging! - November 13, 2017 Category: Research Authors: Reason Tags: Daily News Source Type: blogs
