Clinical
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FDA Actions
FDA approves reversal agents, signs off on schizophrenia drug, warns of liver damage associated with hepatitis C treatment, green lights hyperkalemia treatment, and approves the first oncolytic virus for the treatment of melanoma.
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Rethinking Calcium Supplementation
Increasing calcium intake from dietary sources or supplements produces small, non-progressive increases in bone mineral density, which are unlikely to make a clinically significant reduction in fracture.
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Infectious Disease Alert Updates
Meningitis Diagnostics
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Anti-parasitic Therapy of Chronic Chagas’ Cardiomyopathy
Two thousand eight hundred fifty-four patients with Chagas’ cardiomyopathy were randomized to benznidazole or placebo, were treated for up to 80 days, and were followed for a mean of 5.4 years. Trypanocidal treatment with benznidazole reduced serum parasite detection but did not reduce clinical cardiac deterioration.
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Oritavancin: Formulary Considerations
Oritavancin is a lipoglycopeptide bactericidal antibiotic for intravenous administration with activity against Gram-positive organisms, including methicillin-resistant Staphylococcus aureus.
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Acetaminophen for Fever in the ICU
Seven hundred ICU patients with fever and known or suspected infection were randomly assigned to receive acetaminophen 1 g IV or placebo every 6 hours until ICU discharge, resolution of fever, cessation of antimicrobial therapy, or death. Early administration of acetaminophen did not affect number of ICU-free days.
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Dual Combination ART with Cabotegravir and Rilpivirine Is Effective for Maintaining HIV Virological Suppression
Results of the phase 2 LATTE study show that after 24 weeks of induction triple therapy, maintenance therapy with cabotegravir (a long-acting dolutegravir analogue) and rilpivirine led to virological suppression in 82% of patients, compared to 71% who received efavirenz plus two NRTIs.
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Cutaneous Leishmaniasis in Syrian Refugees
Cutaneous leishmaniasis is spreading as refugees move from Syria through Turkey into Europe and throughout the world. Aware clinicians can consider diagnostic testing when facing unusual skin lesions in refugees.
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Xenotourism: Live Cell Therapy, Maybe Not So Therapeutic
ABSTRACT & COMMENTARY: Beware injection with sheep fetal cells.
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Chronic Obstructive Pulmonary Disease: Update
Over the past decade, this definition of COPD has changed dramatically, as has the characterization and treatment of individuals with COPD. Multiple new therapies alter the course of this disease, reduce exacerbations, improve quality of life, and increase survival; previous nihilistic approaches to the management of COPD have been replaced by directed and effective pharmacologic and nonpharmacologic therapies. This update will review current approaches to the diagnosis and management of COPD and present the most recent evidence for the classification of COPD phenotypes and the implications of these categories for COPD treatment and prognosis.