Use of Ceftriaxone and Benzylpenicillin in Outpatient Parenteral Antimicrobial Therapy: Spectrum vs Cost.

Background: The application of antimicrobial stewardship (AMS) principles may entail increased cost to allow for narrower-spectrum therapy. Prescribing benzylpenicillin (BP) and ceftriaxone (CRO) for outpatient parenteral antimicrobial therapy (OPAT) demonstrates the complex challenge of this principle. The aim of this study is to analyze the use of BP and CRO in our OPAT program, including indications and relative cost.

Multidisciplinary team meetings appear to be effective in inflammatory bowel disease management: an audit of process and outcomes.

Background: Multidisciplinary team meetings (MDTM) have proven efficacy in cancer management. Whilst widely implemented in inflammatory bowel disease (IBD) care, their value is yet to be investigated. We reviewed the performance of MDTM for IBD patients.

Vedolizumab: a novel treatment for ipilimumab-induced colitis.

Use of the immune checkpoint inhibitors, ipilimumab and nivolumab, has revolutionised treatment in patients with metastatic melanoma. However, these drugs can cause an autoimmune enterocolitis, with diarrhoea as the presenting symptom. This is conventionally managed by prompt institution of corticosteroid therapy if moderate diarrhoea (3-6 times/day; grade 2) is present for >5 days or if diarrhoea is severe (>6 times/day; grade 3).

Coronary embolism causing acute myocardial infarction in a patient with mitral valve prosthesis: successful management with angioplasty.

A 24-year-old male patient with anterior myocardial infarction, caused by embolization from mitral valve prosthesis due to inadequate anticoagulation is presented. The patient underwent cardiac catheterization within 90 minutes of arrival. Angiography showed total occlusion of the left anterior descending coronary artery (LAD) after the second diagonal branch.

On the sources of summertime haze in the eastern United States.

The summertime haze transported from the Gulf Coast northward in maritime tropical air masses is partially formed from emissions in the midwestern and northeastern United States. Several cases are documented in which sulfate particulates, formed from emissions in the Midwest and Northeast, traveled to the Gulf of Mexico and, in some cases, returned to their source regions.