IDSA, SHEA UPDATE GUIDANCE FOR MANAGING PATIENTS WITH C. DIFFICILE
The Infectious Diseases Society of America and The Society for Healthcare Epidemiology of America, or SHEA, have released new guidelines for the management of Clostridioides difficile infection (CDI). These guidelines are intended to be complementary to the recently updated Infectious Disease Society of America (IDSA) and Society of Healthcare Epidemiologists of America (SHEA) guidelines. Some of the recommendations include: Fidaxomicin is preferred over oral vancomycin for first cases of CDI; Fidaxomicin as either continuous or pulse therapy is recommended over oral vancomycin for cases of recurrent CDI; Bezlotoxumab is recommended as additional therapy for CDI that has recurred within 6 months.
Full Access: HEALIO
TRENDS IN RESPIRATORY VIRUS INFECTIONS DURING THE COVID-19 PANDEMIC IN SINGAPORE, 2020.
In this cross-sectional study, data from respiratory virus multiplex polymerase chain reaction tests from 3 major public hospitals in Singapore for 2019 and 2020 were compiled. During reopening, low levels of all viruses were sustained for approximately 13 weeks, but a reemergence of enterovirus/rhinovirus occurred in early September and a less pronounced rebound of adenovirus in mid-October. For enterovirus/rhinovirus and adenovirus, reductions were only seen after lockdown, and these viruses rebounded earlier than others. Most other viruses remained at historically low levels until the end of the year, despite reopening businesses and schools (with mask wearing) and gradual resumption of activities.
Full Access: JAMA
AN OMINOUS TREND FOR URGENT CARE
Urgent care industry is facing an ominous and pernicious trend. Are we excessively referring injuries, minor fractures, sprains, tendinitis, injections, basic eye injuries, long lacerations, minor head injuries, burns, fingertip injures; instead of treating them ourselves? Unnecessary referrals and overcrowding Emergency Departments will train your community not to come to your Urgent Care. Advancing the specialty is in our hands, and as clinicians, we must provide high quality of care while appropriately treating “bread and butter” Urgent Care cases.
Full Access: JUCM
PEDIATRIC LIFE SUPPORT CLINICAL PRACTICE GUIDELINES (ERC, 2021)
Pediatric Advanced Life Support (PALS) was designed for pediatric healthcare providers at all levels and taught basic approaches to pediatric cardiopulmonary arrest with a heavy emphasis on algorithms. Clinical practice guidelines on pediatric life support were published in April 2021 by the European Resuscitation Council (ERC) in resuscitation. The ERC guidelines apply to children aged 0-18 years, with the exception of newborn infants.
Full Access: Medscape
SPERM PARAMETERS BEFORE AND AFTER COVID-19 mRNA VACCINATION
One of the reasons for vaccine hesitancy is the potential negative effect on fertility. This single-center prospective study found that after the second vaccine dose, the median sperm concentration significantly increased to 30 million/mL (IQR, 21.5-40.5; P = .02) and the median total motile sperm count to 44 million (IQR, 27.5-98; P = .001). Semen volume and sperm motility also significantly increased. No man became azoospermic after the vaccine.
DIAGNOSIS AND MANAGEMENT OF HEADACHE – A REVIEW
Headache disorders affect approximately 90% of people during their lifetime. Among primary headache disorders, migraine is most debilitating and can be treated acutely with analgesics, nonsteroidal anti-inflammatory drugs, triptans, gepants, and lasmiditan. Diagnostic testing, including neuroimaging, should be performed for patients who present with headache with abrupt onset, neurologic signs, age ≥50 years, comorbidities including cancer or immunosuppression, or provocation by physical activities or postural changes.
Full Access: JAMA
A RANDOMIZED CONTROLLED TRIAL OF IBUPROFEN VERSUS KETOROLAC VERSUS DICLOFENAC FOR ACUTE, NON-RADICULAR LOW BACK PAIN
Study compared ibuprofen, ketorolac, and diclofenac for the treatment of acute, non-radicular Lower Back Pain. Improvements in Roland Morris Disability Questionnaire (RMDQ)
by day 5 were as follows: ibuprofen 9.4, ketorolac 11.9, diclofenac 10.9. There were no important differences between groups with regard to the primary outcome. These data do not rule out that possibility that ketorolac results in better pain relief and less stomach irritation than ibuprofen.
Full Access: Academic Emergency Medicine
ACUTE ISCHEMIC STROKE DURING THE CONVALESCENT PHASE OF ASYMPTOMATIC COVID-2019 INFECTION IN MEN
In this case series of 18 male adults aged 50 years or younger who presented with Acute Ischemic Syndrome during the convalescent phase of an asymptomatic COVID-19 infection confirmed by a positive SARS-CoV-2 serological (antibodies) test result, the median onset of stroke was 2 months after the diagnosis of COVID-19. Acute ischemic stroke could be part of the next wave of complications of COVID-19.
Full Access: JAMA
DELTA VARIANT AND COVID-19 VACCINES: WHAT TO KNOW
Health experts are reiterating the importance of getting the COVID-19 vaccine. A preprint study conducted in the United Kingdom finds that one dose of the Pfizer vaccine provided about 33% protection against the Delta variant. In Northern Ireland, the gap between the first and second doses of the AstraZeneca and Pfizer vaccines is being cut to 8 weeks from 10-12 weeks to offer more protection against the Delta variant. Stomach pain, nausea, vomiting, loss of appetite, hearing loss, and joint pain are among the symptoms now being seen in India.
Full Access: MEDSCAPE