Morbidity and mortality rates are high among adult patients with acute bacterial meningitis especially those with pneumococcal meningitis. Animal studies have shown that bacterial lysis occuring with antibiotic treatment leads to inflammation in the subarachnoid space and that treatment with dexamethasone, an anti-inflammatory agent, reduced cerebrospinal fluid inflammation and neurologic sequelae (Tauber, et al., J Infect Dis.,
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Journal Review
Dexamethasone in Adults with Bacterial Meningitis
Core
Alcoholic Ketoacidosis
An overview of ketoacidosis, a diagnosis that can be easily missed.
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Journal Review
Cervical Spine Injury Risk Factors in Children with Blunt Trauma
Pediatric cervical spine injuries (CSI) are rare (1-2%) after blunt trauma. Decision rules to identify adults at low risk of cervical spine injury have been developed (NEXUS criteria (Hoffman, NEJM 2000, PMID: 10891516), Canadian C-spine rule (Stiell, JAMA 2001, PMID: 11597285)). A pediatric rule was developed as a subset of the Nexus study (Vicellio, Pediatrics 2001,
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Ovarian Hyperstimulation Syndrome
An overview of Ovarian Hyperstimulation Syndrome (OHSS).
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Language as Key: Unlocking patients’ stories with shared culture
There is a man living in New York City who once suffered a traumatic brain injury and is now frequently brought into our ED by EMS with a chief complaint of “seizure.” Often providers order labs, imaging and medications, prescriptions he doesn’t fill and make clinic appointments he never attends. He appears disheveled so many assume he is addicted to alcohol and has seizures due to withdrawal.
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Journal Review
Thrombolysis with Alteplase 3 to 4.5 Hours after Acute Ischemic Stroke
Stroke is one of the leading causes of death in the United States. Approximately 87% of all strokes are ischemic. Available therapies are limited and include thrombolysis and thrombectomy. There is a known risk of hemorrhagic conversion of acute ischemic strokes with the use of thrombolytics. Of the 12 clinical trials comparing thrombolysis vs. either placebo or no treatment for acute ischemic stroke,
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