A mini review of inhaled beta 2 agonists in acute decompensated heart failure requiring respiratory support.

Acute decompensated heart failure (HF) results in over one million hospital admissions per year, many requiring invasive or noninvasive mechanical ventilation for respiratory/cardiovascular support. Inhaled beta-2 adrenergic receptor agonists have been shown to be effective at clearance of extravascular lung water in HF patients. However, studies done in the late 1990s and early 2000s, prior to standardization and wide adoption of guideline directed medical therapy for HF, suggested that inhaled beta-2 agonist use increased admissions for HF exacerbations as well as in-hospital mortality.

Group B streptococcus meningitis complicated by periodic lateralising epileptiform discharges in an elderly patient with type 2 diabetes mellitus.

(group B streptococcus or GBS) is the most common cause of bacterial meningitis in infants, but is rarely the cause in adults. Across all non-pregnant adults it comprises 7% of bacterial meningitis cases, with a mortality rate of 56% in the elderly. Therefore, while rare, GBS should be a part of a patient's differential when initiating antibiotics in adults with chronic illnesses.

A Case of Postablation Pericardial Effusion.

Complications of atrial fibrillation ablation include pericardial effusion, which tends to occur acutely. Large and hemodynamically important effusions are uncommon, but a small effusion may be present at the end of the procedure in up to 22% of ablations. We monitor for pericardial effusions routinely after ablation with intracardiac echocardiography.