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Twice in the past 2 years I've encountered pulmonary histoplasmosis in travelers returning from Central America (Mexico and Costa Rica), and both times the diagnosis proved challenging. One case, in particular, was a 60-year-old man who had traveled to Costa Rica for 1 week and then presented with fever, persistent dry cough, malaise, and complaints of memory loss.
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Herpes zoster vaccine (Zostavax) was licensed in the United States in 2006 subsequent to the publication of the Shingles Prevention Study, a large (n = 38,546) prospective trial that demonstrated a 51% reduction in zoster and a 67% reduction in postherpetic neuralgia in vaccines compared to controls.
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Leptospirosis is a zoonosis caused by multiple serovars of bacteria in the genus Leptospira that are widely distributed in the tropics, as well as some subtropical and temperate areas.
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Admissions to a public hospital in kwazulu-natal, South Africa, for treatment of MDR- and XDR-TB from 2003 to 2008 were examined for health care workers (HCWs) compared with non-HCWs.
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In this issue: Anticholinergic drugs for COPD; pioglitazone for diabetes prevention; insulin degludec in Phase 3 trials; and FDA Actions.
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If your ED patient sustained a few rib fractures, would you expect this to lead to rapid respiratory decompensation, pneumonia, and death? Minor injuries can have profound effects in the elderly, warns Avery Nathens, MD, division head of trauma and general surgery at St. Michael's Hospital in Toronto, Canada.
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If ED nurses believe a patient poses a risk of harm to themselves or others, a patient safety checklist is used for "closed-loop" communication with security, says Alexandra Penzias, RN, MEd, MSN, CEN, clinical nurse educator in the department of emergency medicine at Tufts Medical Center in Boston, MA. "This ensures that all members of the ED team are aware of the patient's status and plan of care," she explains.
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Is a cardiac-arrest patient failing to wake up and follow commands? "Therapeutic hypothermia is one of the few therapies we can offer," says Marion Leary, BSN, RN, assistant director of clinical research at the Hospital of the University of Pennsylvania's Center for Resuscitation Science in Philadelphia.
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Editor's Note: This is a two-part series on medication safety for inpatients being held in the ED. This month, we give strategies to reduce errors with inpatient medications. Last month, we gave strategies to avoid missed dosages.
