Current Articles that Matter

Olson D, Watkins LK, Demirjian A, et al. Outbreak of Mycoplasma pneumoniae-Associated Stevens-Johnson Syndrome. Pediatrics 2015; 136:e386.

Peters AL, Buschur EO, Buse JB, et al. Euglycemic Diabetic Ketoacidosis: A Potential Complication of Treatment With Sodium-Glucose Cotransporter 2 Inhibition. Diabetes Care 2015; 38:1687.

Tomas ME, Kundrapu S, Thota P, Sunkesula VC, Cadnum JL, Mana TS, Jencson A, O'Donnell M, Zabarsky TF, Hecker MT, Ray AJ, Wilson BM, Donskey CJ. Contamination of Health Care Personnel During Removal of Personal Protective Equipment. JAMA Intern Med. 2015;

Proper technique is crucial in reducing contamination when doffing PPE. They found removing gloves vs gowns was riskier for contamination- as were witnessed lapses- suggesting feedback improves technique. With Ebola still lurking, this matters!

CDC Health Advisory. Ciprofloxacin- and Azithromycin-Nonsusceptible Shigellosis in the United States. http://emergency.cdc.gov/han/han00379.asp.

Mimoz O, Lucet JC, Kerforne T, et al. Skin antisepsis with chlorhexidine-alcohol versus povidone iodine-alcohol, with and without skin scrubbing, for prevention of intravascular-catheter-related infection (CLEAN): an open-label, multicentre, randomised, controlled, two-by-two factorial trial. Lancet 2015.

Friedlander AM. Management of potential bioterrorism-related conditions. N Engl J Med. 2015 Jun 4;372(23):2272.

WHO Ebola Response Team. Ebola virus disease in West Africa--the first 9 months of the epidemic and forward projections. N Engl J Med. 2014 Oct 16;371(16):1481 95.

Landmark Articles

Marik PE, Flemmer M, Harrison W. The risk of catheter-related bloodstream infection with femoral venous catheters as compared to subclavian and internal jugular venous catheters: a systematic review of the literature and meta-analysis. Crit Care Med. 2012;40(8):2479-85.

ACT Investigators. Acetylcysteine for prevention of renal outcomes in patients undergoing coronary and peripheral vascular angiography: main results from the randomized Acetylcysteine for Contrast-induced nephropathy Trial (ACT). Circulation. 2011 Sep 13;124(11):1250-9. doi: 10.1161/CIRCULATIONAHA.111.038943. Epub 2011 Aug 22.

CONCLUSIONS: In this large randomized trial, we found that acetylcysteine does not reduce the risk of contrast-induced acute kidney injury or other clinically relevant outcomes in at-risk patients undergoing coronary and peripheral vascular
angiography. PMID: 21859972

Comment: Previous studies have suggested NAC may prevent contrast nephropathy.  In 2308 patients with at least one risk factor for contrast nephropathy, there was no difference in contrast induced acute kidney injury or need for dialysis in patients who received NAC 120mg BID pre and post-contrast.  NAC confers no benefit in preventing contrast-induced kidney injury.

NICE-SUGAR Study Investigators, Finfer S, Chittock DR, Su SY, Blair D, Foster D, Dhingra V, Bellomo R, Cook D, Dodek P, Henderson WR, Hébert PC, Heritier S, Heyland DK, McArthur C, McDonald E, Mitchell I, Myburgh JA, Norton R, Potter J, Robinson BG, Ronco JJ. Intensive versus conventional glucose control in critically ill patients. N Engl J Med. 2009;360(13):1283-97.

Marenzi G, Assanelli E, Marana I, Lauri G, Campodonico J, Grazi M, De Metrio M, Galli S, Fabbiocchi F, Montorsi P, Veglia F, Bartorelli AL. N-acetylcysteine and contrast-induced nephropathy in primary angioplasty. N Engl J Med. 2006;354(26):2773-82.

Moran GJ, Krishnadasan A, Gorwitz RJ, Fosheim GE, McDougal LK, Carey RB, Talan DA; EMERGEncy ID Net Study Group. Methicillin-resistant S. aureus infections among patients in the emergency department. N Engl J Med. 2006 Aug 17;355(7):666-74.

Wong CH, Khin LW, Heng KS, Tan KC, Low CO. The LRINEC (Laboratory Risk Indicator for Necrotizing Fasciitis) score: a tool for distinguishing necrotizing fasciitis from other soft tissue infections. Crit Care Med. 2004;32(7):1535-41.

van den Berghe G, Wouters P, Weekers F, Verwaest C, Bruyninckx F, Schetz M, Vlasselaers D, Ferdinande P, Lauwers P, Bouillon R. Intensive insulin therapy in critically ill patients. N Engl J Med. 2001;345(19):1359-67.

Schriger DL, Mikulich VJ; Centers for Disease Control and Prevention. The management of occupational exposures to blood and body fluids: revised guidelines and new methods of implementation. Ann Emerg Med. 2002 Mar;39(3):319-21.