Sermo - so what's new?

Back story here.

ACE inhibitor may prevent cardiotoxicity from chemotherapy According to one study published in the journal Circulation, 43 percent of controls and no patients in the ACE inhibitor group experienced a 10 percent units decline in the pumping efficiency of the heart after chemotherapy.

Colloid for cirrhotics- FFP or albumin? When a patient with cirrhosis is admitted, whether with a GI bleed or with renal dysfunciton, and is thought to be dehydrated or requires intravascular volume, many physicians give normal saline.

Platelet transfusion for head bleeds An interesting question was raised at one of our recent clinical meetings. It is well known and established that patients on coumadin/warfarin presenting to the Emergency Department with a head injury, and found to have a bleed.

Optimal treatment for hot flashes After the results of the WHI, many of my patients went off of their HRT, only to suffer from significant hot flashes.

Bypass and interoperative stroke One of the major complications associated with cardiopulmonary bypass surgery is the occurrence of interoperative stroke.

Will Medicare patients go the way of Medicaid? With Medicare constantly cutting procedure fees, such as for surgeries and endoscopies, will more and more physicians choose to not see Medicare patients in the future?

Easy way to reduce a paraphimosis For those of you who have had to reduce a paraphimosis in the past, it can be a difficult task at best. Trying to reduce a swollen foreskin behind a tight band is hard enough.

ED treatment of migraine Review of ED literature suggests the use of narcotic analgesics in the treatment of suspected vascular headaches is not optimal.

Hypertension and spinal cord injury I have a patient, a 50 YO M with a long standing spinal cord injury, who has had hypertension which I've treated with atenolol 25, felodipine 10, and and ace inhibitor at maximal doses.

Blood product consent for administration of RhoGam Our hospital policy requires that all patients treated with RhoGam sign a blood product consent prior to administration. This is a relatively new policy and was not required in the past.

Tamiflu FDA warning of abnormal behavior The FDA added "abnormal behavior" to the warning label for Tamiflu today. There were 103 cases reported and mostly in Japan. They described cases of suicidal ideations, delerium, and aggression.

Vitamin D supplemenation reduces risk of DM type 1I n a study in Lancet (Lancet. 2001 Nov 3;358(9292):1500-3) which was a very large study in Finland (12000 subjects) they concluded that dietary vitamin D significantly reduces the risk of type 1 DM.

Steroids for pediatric migraine Migraine headache can be a difficult condition to manage in the Emergency Department. Triptans, ergotamines, analgesics, metoclopromide have all been used.

The dying patient in the EDA while back an elderly woman was brought in, unconscious & unresponsive to my ED. Her vital signs were stable, but her CT scan showed a large intracerebral bleed. While her body was still alive, her brain was dead.

Flu shot and Guillain-Barre Syndrome 24 year old female without significant PMH, presented with bilateral hand numbness, feet numbness, unsteady gait for 3-4 days, She had flu shot 4 weeks ago.

Rapid Strep Screens How accurate are rapid Strep screens? I've been seeing a lot of people with positive screens. But I've also been seeing quite a few with negative screens who really looked like they should have been positive.

NSAIDs and a PPI vs COX 2 inhibitors Given the recent disclosure of cardiovascular events associated with COX 2 inhibitors, should we instead be using ibuprofen and a proton pump inhibitor instead of COX inhibitors for analgesia?

Pretreating NG Tube Insertion with Metoclopramide I recently read an article in the internal medicine literature about decreasing the pain and nausea of an nasogastric tube insertion by pretreating with 10 mg of intravenous metoclopramide.

NADH use in augmenting antidepressants? Is anyone aware of, or does anyone prescribe NADH -- nicotinamide adenine dinucleitide phosphate -- for increasing energy in patients with depression treated except for the anergia?

Antibiotics for cough in children In over 30 years of pediatric practice, I have concluded that in a group of children who have been coughing for over two to three weeks, showing no other symptoms or signs of illness, with or without nasal symptoms, I am not able to pre-define clinically if an antibiotic course would be beneficial.