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Approximately 10% of all patients with middle cerebral artery (MCA) territory cerebral infarction suffer progressive deterioration due to cerebral edema, increased intracranial pressure, and brain herniation. In these patients with malignant MCA territory infarction aggressive decompressive craniectomy has been reported to improve overall prognosis.
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How does one physiologically explain ulnar neuropathies at the elbow that clinically localize to the wrist? Why do proximal sciatic neuropathies sometimes masquerade clinically as peroneal neuropathies at the knee? In this lucid, well-articulated review, Stewart thoroughly and evenhandedly comments on the literature going back to 1913, convincingly arguing that nerve fibers do not randomly intertwine as they progress distally in nerve bundles.
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Ventilator-associated pneumonia (VAP) is nosocomial pneumonia occurring in a mechanically ventilated patient > 48 hours after intubation. It is categorized as early-onset (defined by most experts as 48-96 hours after intubation) and late-onset (> 2-96 hours after intubation): these differ with respect to responsible bacterial agents as well as outcomes.
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The FDA has approved Telithromycin, the first Ketolide antibiotic. Ketolides are semisynthetic derivatives of the macrolide erythromycin that have activity against a wide spectrum of respiratory bacterial pathogens including multi-drug resistant Streptococcus pneumoniae. Telithromycin, which is a once-a-day oral tablet, is marketed by Aventis as Ketek.
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A patient with a disease resembling anthrax led to the identification of anthrax-like virulence factors in an isolate of Bacillus cereus.
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Musher and colleagues in Houston examined the usefulness of examination of Gram-stained sputum specimens and of sputum culture for the diagnosis of pneumococcal pneumonia. They included all 105 patients with bacteremic pneumococcal pneumonia seen over 6 years at their VA hospital, and examined the results of the first sputum specimen submitted to the laboratory.
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New guidelines for the treatment of bacterial rhinosinusitis were published in the January supplement of Otolaryngology-Head and Neck Surgery by the Sinus and Allergy Health Partnership. The goal of the guidelines is to reduce the use of antibiotics for viral infections and to use the most appropriate antibiotic for bacterial infections.
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Braun BI, et al. Preventing central venous catheter-associated primary bloodstream infections: Characteristics of practices among hospitals participating in the evaluation of processes and indicators in infection control (EPIC) study.
