Tag Archives: nejm

Albumin replacement does not improve survival from sepsis – NEJM

The New England Journal of Medicine published the results of a trial by Caironi et al in the March 18th issue comparing survival in patients admitted with sepsis who did or did not receive albumin as part of the resuscitation.

The study found no survival advantage to giving albumin in addition to crystalloids.

Reference

NEJM review on fluid resuscitation

The September 26th issue of The New England Journal of Medicine published a review by Myburgh et al on resuscitation fluids.

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Sepsis – New England Journal review

The August 29th issue of The New England Journal of Medicine published a review on sepsis and septic shock.

Outcomes of Medical Emergencies on Commercial Airline Flights – NEJM

The May 30th issue of the New England Journal of Medicine features an article that addresses the common in-flight medical emergencies encountered and their outcomes [1]. Additionally it covers the liability and expectations of providing help.

The summary

Most in-flight medical emergencies were related to syncope, respiratory symptoms, or gastrointestinal symptoms, and a physician was frequently the responding medical volunteer. Few in-flight medical emergencies resulted in diversion of aircraft or death; one fourth of passengers who had an in-flight medical emergency underwent additional evaluation in a hospital.

Duodenal infusion of donor feces for recurrent Clostridium difficile

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Recurrent refractory Clostridium difficile infection has been a cause of significant morbidity. There have been years of anecdotal case reports of successful fecal transplant.[1][2][3] This study [4] published in the January 31st 2013 issue of New England Journal of Medicine describes resolution of symtoms in 13 of 16 patients treated with single duodenal infusion of feces.
Feces was collected on the day of infusion from prescreened volunteers, processed and administered within 6 hours of collection via nasoduodenal tube. The feces was diluted with 500 ml of sterile water, stirred, strained before administration.
All patients in the study first received oral vancomycin followed by bowel prep with 4 liters of macrogol solution on the last day of antibiotic treatment.

Combination Antifungal Therapy is better for Cryptococcal Meningitis – NEJM

Recent article published in the Apr 4th issue of the New England Journal of Medicine published an original paper by J. Day et al comparing the efficacy of combination amphotericin B with flucytosine for the treatment of cryptococcal meningitis versus use of amphotericin alone 1.

The combination of Amphotericin B with Flucytosine was superior to Amphotericin alone for the treatment of cryptococcal meningitis

Use of fluconazole with amphotericin B did not show any added benefit.