- Latest IDSA clinical practice guideline for management
Latest Updates
- Zika virus: Delayconception if potential exposure: 8 weeks: females or 3 months: males
- Subclinical hypothyroid: Treatment is associated with improved pregnancy outcomes when TSH levels are above 4 mIU/L.
- Tubal patency: Hysterosalpingo-contrast sonography was recently introduced as an additional screening method to assess tubal patency.
Clinical Evaluation of Immigrant and Refugee Women
- Cultural sensitivity and openness is more important than cultural ‘competence’ when treating migrants from diverse backgrounds
- Guidelines are available for effective and appropriate use of qualified medical interpreters
- Mental health screening is not only to assess effects of prior trauma but to determine challenges in acculturation
- There is increasing recognition of the need for preventive counseling and chronic care in migrant women
- Updating consensus guideline recommendations up to January 2016
- Adding a duplex scan image showing a deep vein thrombosis (DVT) in the diagnosis section
- Adding a computed tomographic (CT) scan showing a pulmonary embolism (PE)
- Showing the various types of approved inferior vena cava filters
- Adding five separate flow-chart figures depicting a stepwise management algorithm for the evaluation and treatment of DVT and PE
- Adding a section on catheter-associated upper extremity thrombosis
- Adding a section on extended prophylaxis, the use of non–vitamin K antagonists, updates on stockings
- Writing five new multiple-choice questions based on the review
Iatrogenic Withdrawal Syndromes in Children: A Review of Sedative and Analgesic Weaning
- Many iatrogenic withdrawal syndromes have been identified, the most common of which is opioid or benzodiazepine withdrawal. Generally speaking, the approach to treating opioid and/or benzodiazepine withdrawal is to provide enough medication to saturate target receptors, followed by a period of gradual dose reduction to allow the body to return to a state of homeostasis.
- The Neonatal Abstinence Score (NAS) was designed to assess withdrawal symptoms in infants with multiple drug exposure during pregnancy. Because the NAS was validated in infants, it is not applicable in older children with iatrogenic withdrawal. In recent years, withdrawal assessment tools for pediatrics have been developed for iatrogenic withdrawal to provide an objective assessment of withdrawal.
- There have been no randomized clinical trials that have compared the efficacy of various weaning strategies. However, a recent multicenter clinical trial, named the RESTORE trial, examined the effects of a standardized sedation protocol in pediatric intensive care units.
- Members of the European Organisation for Research and Treatment of Cancer–Invasive Fungal Infection Cooperative Group and National Institute of Allergy and Infectious Diseases Mycoses Study Group formed a consensus committee to develop standard definitions for invasive fungal infections for clinical research.
- The development of standardized methodology for antifungal susceptibility testing is another recent advance in the laboratory evaluation of Aspergillus species. Although azole resistance by Aspergillus species is unusual, patients exposed chronically to antifungal triazoles have been reported to have refractory infection caused by isolates with elevated minimum inhibitory concentrations.
- Fusarium and Scedosporium species are increasingly common causes of infections in surgical patients, especially in recipients of stem cell or organ transplants.
Management of Drug Interactions between Anti-infectives and Common Anesthetics
- Rocuronium-induced neuromuscular blockade is potentiated by a synergistic effect of gentamicin and clindamycin, which may delay recovery.
- Penicillins form a complex with sugammadex, which may interfere with the therapeutically intended sugammadex-rocuronium complex.
- Ondansetron can decrease the analgesic efficacy of acetaminophen at high doses.
- Anesthesiologists are positioned to manage interactions between anesthetic agents and antimicrobials in the operating room.
Part 2: Borderline Personality Disorder and Its Clinical Management
- Although borderline personality disorder has traditionally been perceived as difficult or impossible to treat, significant progress has been made in developing and validating treatments.
- Specialized psychotherapy remains the treatment of choice.
- Short-term or stepped care interventions may represent a more efficient treatment model.
- Common factors, such as structured therapies, may be nearly as effective as specialized treatments.
- Pharmacotherapy plays a limited role in treatment.
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