Treatment of infective endocarditis
Discussion of whole list of options of antimicrobials for different varieties of endocarditis is quite a large topic. This discussion is only a broad outline of the antimicrobial treatment of infective endocarditis, meant mainly for exam purpose rather than actual clinical treatment. References to more detailed guidelines have been provided for those who wish to learn more.
Inoculum Effect
High microbial density as in vegetations cause less antimicrobial activity of some antimicrobial agents. This is known as inoculum effect and has been documented with β-lactams and glycopeptides but not linezolid, in the treatment of St...
Source: Cardiophile MD - July 16, 2021 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology 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
One Barely Noticed Settlement by Pfizer Suggests the Futility of Polite Protests about Health Policy
A few days ago we noticed just one more marcher in theparade of legal settlements. But it was once again a huge health care corporation, and it had aspects that demanded attention.Pfizer Makes $94 Million Settlement of Allegations of Fraud to Delay Generic CompetitionA tinyitem in Becker ' s Hospital News on November 28, 2017, stated:Pfizer will pay $94 million to resolve allegations that it used fraudulent patents to delay generic competition for its anti-inflammatory drug Celebrex.The lawsuit, brought by 32 direct purchasers of Celebrex in April and certified a class action lawsuit in August, claimed Pfizer attempt...
Source: Health Care Renewal - December 3, 2017 Category: Health Management Tags: adverse effects Celebrex deception impunity legal settlements Pfizer restraint of competition Source Type: blogs
MKSAP: 20-year-old male college student with a superficial skin infection
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 20-year-old male college student on the wrestling team is evaluated for a superficial skin infection. He has a history of several episodes of folliculitis and furunculosis over the past year that has required systemic treatment. His recurrent infections were treated with various oral antibiotics, including cephalexin, clindamycin, and trimethoprim-sulfamethoxazole. He currently takes no medications, has no drug allergies, and is otherwise in good health.
On physical examination, vital signs are normal. There a...
Source: Kevin, M.D. - Medical Weblog - July 15, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/mksap" rel="tag" > mksap < /a > Tags: Conditions Infectious disease Source Type: blogs
Notes to myself – 2
Pentobarb coma – BIS should be 10-20 and SR (suppression ratio) should be 70-80
Consider lev albuterol
Should give vaccines after coiling of spleen or before if possible
No calcium channel blockers post MI definitely and post op in general
Toradol inhibits spine healing
Don’t do endoscopes with patients in supine position
don’t ambulate patients with known dvt’s. wait 2-3 days until clots get stuck.
dvt’s even with filter get heparin as much as possible for post phlebitic syndrome and to retard new clot formation
diffuse alveolar hemorrhage – secondary to chemo, goodpasture’s, wege...
Source: Inside Surgery - December 31, 2016 Category: Surgery Authors: Editor Tags: General Source Type: blogs
The nightmare of medicine is the absurd price we have to pay
A grandmother develops a boil that turns out to be a difficult-to-treat staph infection (MRSA). She needs high-powered antibiotics. A middle-aged man who received a blood transfusion decades ago now has hepatitis C and needs anti-viral medicine. A young woman with HIV develops golf-ball-size lesions in her brain, has toxoplasmosis and needs anti-parasite medicine.
The marvel of medicine today is that we can treat all three infections, and save the lives of these patients and countless millions of other Americans. Yet the nightmare of medicine today is the absurd price we have to pay.
Pfizer Pharmaceutical charges $56.31 pe...
Source: Kevin, M.D. - Medical Weblog - January 27, 2016 Category: Journals (General) Authors: Manoj Jain, MD, MPH Tags: Meds Medications Source Type: blogs
Clinician-Led Stewardship To Curb Medical Excess
In a recent New England Journal of Medicine (NEJM) perspective, Durand and colleagues propose “medical-imaging stewardship.” They believe that imaging can be more appropriately used through “provider-led imaging stewardship,” based on the model of antimicrobial stewardship.
Antimicrobial stewardship is a hospital program composed of an expert pharmacist and infectious disease physician. Its goal is to improve appropriateness of antimicrobial use through restriction of antibiotics, post-prescription review, and education. Clinician-led stewardship could limit overuse and improve care beyond antimicrobial use or imag...
Source: Health Affairs Blog - November 30, 2015 Category: Health Management Authors: Dan Morgan Tags: Costs and Spending Health Professionals Hospitals Innovations in Care Delivery Medicare Quality antimicrobials Choosing Wisely Patient Safety patient uses of evidence Physicians Source Type: blogs
Their Cheating Hearts - Latest Allergan Settlement Is a Reminder of Merger Participants' Sketchy Pasts
A Huge, but Sketchy Merger The announced merger and "tax inversion" of Pfizer and Allergan would be one of the largest corporate marriages in US history. It has drawn more than its share of criticism. For example, per the Los Angeles Times, former US Senator and Secretary of State, and current presidential candidate Hilary Clinton said "this proposed merger, and so-called inversions by other companies, will leave U.S. taxpayers holding the bag." By creating the world's largest drug company, it could certainly further consolidate the US and global pharmaceutical market and raise already high drug prices. W...
Source: Health Care Renewal - November 24, 2015 Category: Health Management Tags: Allergan crime deception fraud impunity kickbacks legal settlements obstruction of justice Pfizer RICO Source Type: blogs
Prosthetic valve endocarditis
Brief Review
Prosthetic valve endocarditis is a serious disease with unfavourable outcome. Staph. aureus is the commonest organism in prosthetic valve endocarditis. More complications like paravalvar leak and abscess formation are more common with prosthetic valve endocarditis. Fortunately, the incidence of early prosthetic valve endocarditis has come down, due to better perioperative care and infection control.
There is a difference between mechanical and bioprosthetic valves. The mechanical valves do not allow the adherence of the organism unless there is a thrombus. The infection is most often in the region of the annul...
Source: Cardiophile MD - November 10, 2015 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: General Cardiology Bioprosthetic valves Prosthetic valve endocarditis staph aureus endocarditis Source Type: blogs
Pfizer's Latest International Pfiascos - Charges of Anti-Competitive Practices, Inflated Prices, Deception and Secrecy
Many big health care organizations seem to just be unable to keep out of trouble, and the bigger they are, the more kinds of trouble. Pfizer Inc, considered to be one of the world's largest pharmaceutical companies, has supplied us with plenty of stories. Enough new stories about Pfizer have accumulated since last year to do a roundup. Presented in chronological order....Italy Demands Damages from Pfizer for Anti-Trust ViolationsThis story came out in May, 2014, via Reuters,Italy said on Wednesday it was seeking more than a billion euros in damages from multinational drug companies following a...
Source: Health Care Renewal - September 13, 2015 Category: Health Management Tags: adverse effects antitrust deception executive compensation health care prices legal settlements marketing Pfizer suppression of medical research vaccines Source Type: blogs
Battle of the Bulge: Olecranon Bursitis
Olecranon bursitis, also called baker’s or Popeye elbow, can be a painless or an irritating condition involving the bursa located near the proximal end of the ulna in the elbow over the olecranon. Normal bursae sacs generally are filled with a small amount of fluid, which helps the joint remain mobile. The sac can swell under the soft tissue from overuse or when the area sustains an injury from a bump or fall.
Normal bursae are usually small, but they can grow to be quite large, swollen, and occasionally even infected when they become irritated or inflamed. The swelling is obvious because the space in this area is l...
Source: The Procedural Pause - May 6, 2014 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Battle of the Bulge: Olecranon Bursitis
Olecranon bursitis, also called baker’s or Popeye elbow, can be a painless or an irritating condition involving the bursa located near the proximal end of the ulna in the elbow over the olecranon. Normal bursae sacs generally are filled with a small amount of fluid, which helps the joint remain mobile. The sac can swell under the soft tissue from overuse or when the area sustains an injury from a bump or fall.
Normal bursae are usually small, but they can grow to be quite large, swollen, and occasionally even infected when they become irritated or inflamed. The swelling is obvious because the space in this area is lim...
Source: The Procedural Pause - May 6, 2014 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Notes to myself – 2
Pentobarb coma – BIS should be 10-20 and SR (suppression ratio) should be 70-80
Consider lev albuterol
Should give vaccines after coiling of spleen or before if possible
No calcium channel blockers post MI definitely and post op in general
Toradol inhibits spine healing
Don’t do endoscopes with patients in supine position
don’t ambulate patients with known dvt’s. wait 2-3 days until clots get stuck.
dvt’s even with filter get heparin as much as possible for post phlebitic syndrome and to retard new clot formation
diffuse alveolar hemorrhage – secondary to chemo, goodpasture’s, wege...
Source: Inside Surgery - December 31, 2013 Category: Surgeons Authors: Editor Tags: General Source Type: blogs
Antidepressants: So What's New?
There's some new stuff coming down the pipeline with antidepressants.
~A new antidepressant was approved by the FDA at the end of September. Brintellix, generic: vortioxetine -- could you think of worse names for a medication? From PsychCentral:
The most common side effects reported by participants taking
Brintellix in clinical trials included nausea, constipation and
vomiting. Overall, 5 to 8 percent of the patients who received
Brintellix 5 to 20 mg/day in short-term trials discontinued treatment
due to an adverse reaction, the most common being nausea, compared with 4
percent of placebo-treated...
Source: Shrink Rap - October 20, 2013 Category: Psychiatrists and Psychologists Authors: Dinah Source Type: blogs
Pfizer's Umpteenth Settlement (for $491 Million Plus a Guilty Plea), but No Person Held Responsible
The world's largest research based pharmaceutical company was in court again, as reported by the New York Times, The drug maker Pfizer agreed to pay $491 million to settle criminal and civil charges over the illegal marketing of the kidney-transplant drug Rapamune, the Justice Department announced on Tuesday. In particular, The recent case centers on the practices of Wyeth Pharmaceuticals, which Pfizer acquired in 2009.Rapamune, which prevents the body’s immune system from rejecting a transplanted organ, was approved by the Food and Drug Administration in 1999 for use in patients receiving a kidney tra...
Source: Health Care Renewal - July 31, 2013 Category: Health Medicine and Bioethics Commentators Tags: Wyeth impunity crime marketing Pfizer whistle-blowers legal settlements Source Type: blogs
