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miércoles, 26 de noviembre de 2008


What's New in Medicine
New and Updated Recommendations from Medscape's Clinical Reference October 2008
Herpes zoster (shingles) is 1 of 2 distinctive manifestations of human infection with the varicella-zoster virus (VZV). Read more about the pathophysiology and frequency of herpes zoster.

From Sinusitis, Chronic, Infectious Diseases

Choosing the right antimicrobials for chronic sinusitis

Antibiotic selection depends on several factors, including history of drug allergies, cost of therapy, and the likelihood of involvement by beta-lactamase–producing organisms and MRSA.
From Smallpox, Infectious Diseases

photoSmallpox in the age of bioterrorism: A new vaccine for outbreak control

The vaccine contains live vaccinia virus and works by causing a mild infection that stimulates an immune response that effectively protects against smallpox without actually causing the disease.
From Head and Neck Cancer: Squamous Cell Carcinoma, Plastic Surgery

photoMolecular markers under investigation to individualize treatment of squamous cell carcinoma

Molecular markers such as epidermal growth factor receptors (EGFR) and human papillomavirus (HPV) may help individualize treatment options for squamous cell carcinoma.
Rising Star
Nicholas John Bennett, MBBCh, PhD
Dr. Nicholas Bennett is a resident physician in the department of pediatrics at SUNY Upstate Medical University and is one of the rising stars at eMedicine. He has developed software that helps scientific investigators analyze raw data and developed and teaches a novel communication skills curriculum in pediatrics. At eMedicine, Dr. Bennett is an author in our Infectious Diseases and Pediatrics: General Medicine sections. Energetic, thorough, and always dependable, he recently worked with one of our senior coauthors to submit a comprehensive topic that will be the core of our new HIV section. Our thanks to Dr. Bennett for his enthusiastic dedication to eMedicine.

Dr. Bennett recently coauthored the Infectious Diseases article Avian Influenza.
From Transfusion Reactions, Hematology

Proposed mechanisms for transfusion-related acute lung injury (TRALI)

Two pathophysiologic mechanisms have been proposed for transfusion-related acute lung injury (TRALI).
From Mycobacterium Avium-Intracellulare, Infectious Diseases

photoA potential new diagnostic tool for MAC pulmonary infection

An enzyme immunoassay (EIA) kit used in Japan has been used to detect serum IgA antibody to MAC-specific glycopeptidolipid core antigen. This could be useful for serodiagnosis of MAC pulmonary infection. Sensitivity and specificity of this EIA kit were reported as 84% and 100%, respectively.
From Hepatocellular Carcinoma, General Surgery

photoThe fastest growing cause of cancer mortality overall

Hepatocellular carcinoma, with its link to the hepatitis C epidemic, represents the fastest growing cause of cancer mortality overall and the second fastest growing cause of cancer deaths. Over the past 20 years, the incidence of hepatocellular carcinoma has more than doubled.
From Cardiac MRI - Technical Aspects Primer, Radiology

photoOptimizing MRI technique for the diagnosis and management of cardiac pathology

With an understanding of the technical aspects specific to cardiac MRI, the imager should be able to optimize image quality to aid in the diagnosis and management of these and other cardiovascular diseases.
From Epididymitis, Emergency Medicine

New ways to differentiate epididymitis from testicular torsion

Bedside ultrasonography and C-reactive protein and erythrocyte sedimentation rate are explored as ways to differentiate epididymitis from testicular torsion, a true emergency.
From Immunotherapeutic Targeting, Pediatrics

Toll-like receptor–targeted therapies for pediatric tumors

Animal models have suggested that toll-like receptor (TLR)-targeted therapies may potentially have a role in pediatric tumor regression.
From Mycosis Fungoides, Hematology

photoEvaluation of mycosis fungoides and Sezary syndrome

Fine-needle aspiration biopsy, immunophenotyping, and T-cell receptor gamma chain polymerase chain biopsy may have a role in the evaluation of mycosis fungoides and Sezary syndrome.
From Goiter, Toxic Nodular, Endocrinology

photoHyperactivity of toxic adenomas often results from mutations of the thyrotropin receptor

In 20-80% of toxic adenomas, autonomous nodular hyperactivity is conferred by somatic mutations of the thyrotropin, or thyroid-stimulating hormone (TSH), receptor.
From CADASIL (Cerebral Autosomal Dominant Arteriopathy With Subcortical Infarcts and Leukoencephalopathy), NeurologyNew Article

photoAspirin may increase intracerebral hemorrhage risk in patients with CADASIL

The benefit of antiplatelet agents in the treatment of CADASIL has not been established, and in fact potentially increases the risk of intracerebral hemorrhage.
From Massage, Traction, and Manipulation, Physical Medicine and Rehabilitation

New evidence for an old treatment

A recent Hungarian study indicates that vertical suspension of patients in a warm-water bath, with weight applied to their lower limbs, may, in combination with physical therapy, be an effective treatment for lumbar and cervical diskopathy.
From Penetrating Neck Trauma, Trauma

photoOptimal management of wartime penetrating neck injuries

For the military injury, arteriography remains the criterion standard in the optimal management of penetrating neck injuries, particularly in delayed evaluations.
From Cardiopulmonary Resuscitation (CPR), Clinical Procedures and TherapeuticsNew article

photoWhy ventilations are no longer part of bystander CPR

Studies have concluded that stopping compressions in order to give ventilations may be detrimental to the patient's outcome.
From Atopic Dermatitis, Dermatology

photo2008 guidelines for atopic eczema in children

The incidence of atopic dermatitis continues to increase, and new NICE pediatric treatment guidelines are published for 2008.
From Dry Eye Syndrome, Ophthalmology

Updated therapeutic options for dry eye disease

The International Dry Eye WorkShop (DEWS) recently updated all aspects of dry eye disease, including therapeutic options for dry eye disease treatment.
From Fractionated Stereotactic Radiation for Acoustic Neuroma, Otolaryngology and Facial Plastic Surgery

Long-term results of Gamma Knife radiosurgery studied

A 2008 study by Bush et al analyzes the long-term hearing results of Gamma Knife radiosurgery in treating acoustic neuromas.
From Brain Abscess, Emergency Medicine

Controlling infection and preventing complications

Early administration and selection of appropriate antibiotic therapy for brain abscess are key in controlling infection and preventing complications.
From Os Odontoideum, Orthopedic Surgery

photoStabilizing os odontoideum

In patients with os odontoideum, there are 2 types of management: surveillance and operative stabilization. In patients with more severe symptoms of spinal instability, neurologic involvement, or intractable pain, several surgical options are described in detail, such as onlay fusion, wiring and fusion, screw fixation, and resection of the os fragment.
From Neurofibromatosis, Pediatrics

photoNew treatments for malignant peripheral nerve sheath tumors

New chemotherapy treatments targeting relevant neurofibromatosis pathways have shown great promise in the treatment of malignant peripheral nerve sheath tumors.
From Splinting, Posterior, Long Leg, Clinical Procedures and TherapeuticsNew article

Should NSAIDs be used in the treatment of fractures?

Controversy exists regarding NSAIDs and bone healing, and further investigation is warranted to fully understand which patients are at highest risk for delayed healing and complications produced by NSAIDs.
From Pulmonary Hypoplasia, RadiologyNew article

photoRadiographic findings for pulmonary hypoplasia

On radiographs, pulmonary hypoplasia is usually unilateral, volume of the chest is reduced on the affected side, and the affected lung is small. Antenatal ultrasound and MRI are also being increasingly used to detect pulmonary hypoplasia.
From Skin Grafting, Dermatology

photoSkin substitutes – How much is too much?

Dermal graft substitutes continue to be developed, but cost and other factors limit their usefulness.
From Riedel Thyroiditis, Physical Medicine and Rehabilitation

photoA promising diagnostic tool in Riedel thyroiditis

Although promising, the role of positron emission tomography (PET) scanning in the diagnosis of Riedel thyroiditis (RT) has not yet been established. However, studies indicate that in patients with RT, fluorodeoxyglucose-PET scanning demonstrates increased glucose metabolism in affected thyroids.
From Lysosomal Storage Disease, Neurology

First treatment for Hunter syndrome approved

Many recombinant enzyme-replacement regimens have been developed to treat several lysosomal storage diseases. The latest of these proteins to be produced is idursulfase, the first pharmacologic agent to be approved for the treatment of Hunter syndrome.
From Vocal Fold Paralysis, Bilateral, Otolaryngology and Facial Plastic Surgery

photoBilateral vocal fold paralysis seen after stent placement

A 2008 study by Gellad et al examines bilateral vocal cord paralysis after stent placement for proximal esophageal strictures.
From 3-Beta–Hydroxysteroid Dehydrogenase Deficiency, Pediatrics

A potential complication in 3-beta–hydroxysteroid dehydrogenase deficiency

Rest tumors have been identified as a potential complication in 3-beta–hydroxysteroid dehydrogenase (3BHSD) deficiency that may result in infertility and gonadal dysfunction.
From Paraneoplastic Diseases, Dermatology

Specific HLAs for paraneoplastic pemphigus

Evidence indicates that patients with alleles HLA-Cw14 and HLA-DRB103 may be susceptible to developing paraneoplastic pemphigus.
From Thrombocytosis, Essential, Hematology

photoIs deregulation also involved in polycythemia vera, essential thrombocytosis, and myelofibrosis?

JAK2 mutations activate the JAK-STAT pathway in polycythemia vera and essential thrombocytosis and are linked to myelofibrosis development. The authors hypothesized that a deregulation of the suppressor of cytokine signaling (SOCS) protein system in these cases could produce this activation.

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