The LITFL Review 117
The LITFL Review is your regular and reliable source for the highest highlights, sneakiest sneak peaks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the best and brightest from the blogosphere, the podcast video/audiosphere and the rest of the Web 2.0 social media jungle to find the most fantastic EM/CC FOAM (Free Open Access Meducation) around.
Welcome to the 117th edition, brought to you by:
Kane Guthrie [KG] from LITFL
Tessa Davis [TRD] from LITFL and Don’t Forget The Bubbles
Brent Thoma [BT] from BoringEM, and
Chris Nickson [C...
Source: Life in the Fast Lane - November 26, 2013 Category: Emergency Medicine Doctors Authors: Kane Guthrie Tags: Emergency Medicine Featured LITFL review LITFL R/V Source Type: blogs
More information on azithromycin and the risk of sudden cardiac death
(Source: Notes from Dr. RW)
Source: Notes from Dr. RW - October 4, 2013 Category: Internists and Doctors of Medicine Tags: pharmacology infectious disease cardiovascular Source Type: blogs
Pharmalot... Pharmalittle... Good Morning
Rise and shine, everyone. The middle of the week is here, which is, generally, a busy time. Our morning, in fact, got off to an usually interesting start thanks to National Public Radio and WNYC, a local affiliate, which called us to discuss the Merck reorganization (you can listen here). We do this sort of thing, now and again, in case you were not aware. We are also available for conferences, bar mitzvahs and satires. While you ponder the possibilities, here are some tidbits to start the day. Hope you have a smashing time at work and do stay in touch...
J&J Says Dispute With Boehringer May Cause Doxil Shortage (Bloom...
Source: Pharmalot - October 2, 2013 Category: Pharma Commentators Authors: esilverman Source Type: blogs
Certain Antibiotics Linked to Blood Glucose Swings
By Diane Fennell
People with diabetes who take a certain class of antibiotics are more likely to experience severe swings in blood glucose, according to new research from Taiwan.
Previous research and case reports have raised concern about the possibility of severe high and low blood glucose associated with the use of fluoroquinolones, a class of antibiotics that includes ciprofloxacin (brand name Cipro), levofloxacin (Levaquin), and moxifloxacin (Avelox). One drug in this class, gatifloxacin (Tequin), was removed from the US market due to the risk of blood glucose fluctuations.
To assess the risk of severe blood gluc...
Source: Diabetes Self-Management - August 16, 2013 Category: Diabetes Authors: Diane Fennell Source Type: blogs
Azithromycin and long QT syndrome: Facts from a cardiologist
Text message: “John, This cough and congestion is killing me. It’s turning thick and green. Can you write me a Z-pak? It always works for me.”
If you write a blog on medical decision-making and heart rhythm matters, it seems an incredible omission not to opine on the FDA warning concerning the commonly used antibiotic azithromycin (the drug in a Z-pak). Quoting directly from the FDA warning:
[Azithromycin] can cause abnormal changes in the electrical activity of the heart that may lead to a potentially fatal irregular heart rhythm.
Should we say this more clearly: that simple antibiotic you are taking for a minor inf...
Source: Kevin, M.D. - Medical Weblog - May 4, 2013 Category: Family Physicians Tags: Meds Cancer Medications Source Type: blogs
The FDA Azithromycin Softshoe and Why It Matters
This report was in direct contradiction to an earlier report from Ray, et al. published in the New England Journal of Medicine (and widely hailed in press) (Source: Dr. Wes)
Source: Dr. Wes - May 4, 2013 Category: Cardiology Authors: Westby G. Fisher, MD Tags: Big Data azithromycin safety Source Type: blogs
Top stories in health and medicine, May 2, 2013
Brought to you by MedPage Today.
1. Study Eases Some Azithromycin Fears. Danish patients taking azithromycin were at no greater risk of cardiovascular death, relative to those using penicillin, when pretreatment mortality risk was taken into account.
2. Study: Medicaid Expansion Won’t Help All Aspects of Health. Expanding Medicaid coverage improves mental health but doesn’t tackle some basic measures of physical health, like blood pressure, judging by the experience seen with a Medicaid lottery in Oregon.
3. On-Call Pay Varies Widely by Specialty. Surgeons commanded more than $1,000 a day for being on-call at t...
Source: Kevin, M.D. - Medical Weblog - May 2, 2013 Category: Family Physicians Tags: News Health reform Infectious disease Medicare Medications Source Type: blogs
Danish Study Finds No Increased CV Risk With Azithromycin In General Population
A large observational study found no increased risk for cardiovascular events associated with azithromycin (Zithromax, Pfizer) in a general population of young and middle-age adults. In a paper published in the New England Journal of Medicine, Danish investigators report the results of a large national observational study comparing people who took azithromycin with matched controls who took no antibiotics and with matched controls who took penicillin V for similar indications. Although there was a significant increase in the risk of death from cardiovascular causes in people taking azithromycin compared with people takin...
Source: CardioBrief - May 1, 2013 Category: Cardiology Authors: Larry Husten Tags: People, Places & Events Policy & Ethics Prevention, Epidemiology & Outcomes antibiotics azithromycin FDA Pfizer Zithromax Source Type: blogs
Follow-up: Z-pack is safe for young and middle aged folks
A new report out of Denmark has helped clarify the safety concerns with the antibiotic azithromycin (Zithromax/Zmax, Pfizer). Earlier this year, an analysis of Medicate patients showed an increase risk of death in patients that used Zithromax vs those that used none or amoxicillin. The current study has concluded that on its own, Zithromax does NOT raise the risk of cardiovascular death in patients aged 18-64 years. This was based on 12 years if data. Take home message: - Zithromax is safe to use in patients younger than 65 years of age- Zithromax does slightly raise the risk of CV death in patient...
Source: Dr Portnay - May 1, 2013 Category: Cardiology Authors: Dr Portnay Source Type: blogs
Cardiac Risk With Azithromycin (Zithromax Z-Pack)
A recent FDA warning, indicating that the popular antibiotic azitromycin (commonly known as Zithromax, or Z-Pack), may increase the risk of sudden death in some people, has been widely reported ...Read Full Post (Source: About.com Heart Disease)
Source: About.com Heart Disease - April 8, 2013 Category: Cardiology Source Type: blogs
Best of Medical Blogs - weekly review and blog carnival
The “Best of Medical Blogs - weekly review and blog carnival” is a weekly summary of the best posts from medical blogs. Please email your suggestions for inclusion to clinicalcases@gmail.com. Best of Medical Blogs (BMB) is published every Tuesday, just like the old Grand Rounds.
Choose Wisely when Choosing Wisely http://buff.ly/Wrjs4S
From NBC: "You don’t need an MRI for lower back pain. You don’t need antibiotics for a sinus infection. And you don’t need to be screened for osteoporosis, either, if you’re under 65. A list of 90 medical ‘don’ts.’"
Based on the headlines, one might think that...
Source: Clinical Cases and Images - Blog - April 2, 2013 Category: Professors and Educators Tags: Best of Medical Blogs Source Type: blogs
How safe is a Z-pak?
Text message:
“John, This cough and congestion is killing me. It’s turning thick and green. Can you write me a Z-pak? It always works for me.”
If you write a blog on medical decision-making and heart rhythm matters, it seems an incredible omission not to opine on the FDA warning concerning the commonly used antibiotic azithromycin (the drug in a Z-Pak). Quoting directly from the FDA warning:
[Azithromycin] can cause abnormal changes in the electrical activity of the heart that may lead to a potentially fatal irregular heart rhythm.
Should we say this more clearly: that simple antibiotic you are taking for a minor i...
Source: Dr John M - March 27, 2013 Category: Cardiology Authors: Dr John Source Type: blogs
Lyme Disease
Pathophysiology of Lyme Disease
Lyme disease is an
1) infection with Borrelia burgdorferi via tick bite
2) previous thinking held tick vector was Ixodes but transmission is now thought by some experts to be possible with additional tick species
3) occurs in stage I and stage II days to weeks after infection and in stage III months to years after infection (usually with preceding latency period
Signs and Symptoms
Stage I
1) characteristic expanding annular rash with central clearing (“bull’s eye or “target” rash) that occurs in only 40% of infections
Stage II
2) multiple secondary annular skin lesio...
Source: Inside Surgery - March 19, 2013 Category: Surgeons Authors: Editor Tags: Infectious Disease babesia bulls eye rash coinfections deer tick erythema migrans hyperbaric ixodes target rash Source Type: blogs
