Fever of unknown origin: a clinical approach.

Fevers of unknown origin remain one of the most difficult diagnostic challenges in medicine. Because fever of unknown origin may be caused by over 200 malignant/neoplastic, infectious, rheumatic/inflammatory, and miscellaneous disorders, clinicians often order non-clue-based imaging and specific testing early in the fever of unknown origin work-up, which may be inefficient/misleading. Unlike most other fever-of-unknown-origin reviews, this article presents a clinical approach.

Pharmacotherapy for alcohol use disorder: current and emerging therapies.

Alcohol use disorder is a heterogeneous illness with a complex biology that is controlled by many genes and gene-by-environment interactions. Several efficacious, evidence-based treatments currently exist for treating and managing alcohol use disorder, including a number of pharmacotherapies that target specific aspects of biology that initiate and maintain dangerous alcohol misuse. This article reviews the neurobiological and neurobehavioral foundation of alcohol use disorder, the mechanisms of action and evidence for the efficacy of currently approved medications for treatment, and the literature on other emerging pharmacotherapies.

Dual-camera technique for arthroscopic rotator cuff repair.

An all-arthroscopic rotator cuff repair demands a high level of technical skill and is associated with a steep learning curve. It is well accepted that small rotator cuff tears or partial tears can be more difficult than large or even massive tears to repair. Part of the reason is the difficulty in visualizing the tear, as well as important surrounding structures, during repair.

Middle East respiratory syndrome (MERS): a new zoonotic viral pneumonia.

Coronaviruses have traditionally been associated with mild upper respiratory tract infections throughout the world. In the fall of 2002, a new coronavirus emerged in in Asia causing severe viral pneumonia, i.e.

Efficacy and safety of phenylephrine in the management of low systolic blood pressure after renal transplantation.

Background: Phenylephrine can be used to treat postoperative hypotension after renal transplantation. However, its effect on the renal allograft is unknown. We evaluated the safety and efficacy of this approach.

Career paths and practice patterns of global emergency medicine physicians: a cross-sectional survey.

Background: Increasing numbers of emergency medicine (EM) residents and fellows are completing additional training with the intention of pursuing careers in global emergency medicine (GEM). At the same time, many academic emergency departments (EDs) are investing in the development of GEM divisions and global/international EM fellowship programs. However, the path for a successful career in this subspecialty has still not been defined.

More than just a hobby: building an academic career in global emergency medicine.

Background: As the specialty of emergency medicine (EM) continues to spread around the world, a growing number of academic emergency physicians have become involved in global EM development, research, and teaching. While academic departments have always found this work laudable, they have only recently begun to accept global EM as a rigorous academic pursuit in its own right.

Objective: This article describes how emergency physicians can translate their global health work into "academic currency" within both the clinician-educator and clinician-researcher tracks.

Cost benefit analysis of topical tranexamic acid in primary total hip and knee arthroplasty.

The purpose of this study was to provide a cost-benefit analysis of topical tranexamic acid (TXA) in primary total hip and knee arthroplasty patients. A retrospective cohort of 591 consecutive patients, 311 experimental and 280 control, revealed a transfusion rate reduction from 17.5% to 5.

Magnesium sulfate for cerebral palsy prevention.

Magnesium sulfate (MgSO4) has been shown to prevent cerebral palsy among children born to women at high risk of early preterm delivery. Three large, randomized placebo-controlled trials and a subsequent Cochrane Review suggest this intervention can decrease rates of cerebral palsy by 32% with a number needed to treat of 63 to prevent one case. Not only is MgSO4 familiar to obstetricians, it also has an excellent safety profile.

Guidance on preparing an investigational new drug application for fecal microbiota transplantation studies.

Fecal microbiota transplantation (FMT) is an effective treatment for Clostridium difficile infections that are refractory to antibiotic therapy. Because of the important roles of the microbiota in the function of the gastrointestinal tract and other aspects of human physiology, there is a growing interest in studying FMT for other clinical indications. The US Food and Drug Administration regulates clinical studies to evaluate the safety and efficacy of FMT.

Transient flare of ulcerative colitis after fecal microbiota transplantation for recurrent Clostridium difficile infection.

Clostridium difficile infection (CDI) is a common cause of infectious diarrhea and is usually treated with metronidazole or vancomycin. CDI recurs in 15%-30% of patients after the initial episode and in up to 65% after a second episode. Recurrent infections are a challenge to treat, and patients are usually managed with prolonged pulsed or tapered vancomycin.

Evaluation of the clinical use of magnesium sulfate for cerebral palsy prevention.

Objective: Clinical trials support the efficacy and safety of magnesium sulfate for cerebral palsy prevention. We evaluated the implementation of a clinical protocol for the use of magnesium for cerebral palsy prevention in our large women's hospital, focusing on uptake, indications, and safety.

Methods: We performed a review of selected gravidas with threatened or planned delivery before 32 weeks of gestation from October 2007 to February 2011.

Fecal microbiota transplantation for relapsing Clostridium difficile infection in 26 patients: methodology and results.

Goals: We aim to present a data detailing our success with fecal microbiota transplantation (FMT) and to provide a simple treatment protocol.

Background: Relapse is a common problem in patients treated for Clostridium difficile infection, often requiring prolonged courses of oral vancomycin with limited alternative treatment options. Administration of the entire fecal flora from a healthy individual to restore beneficial physiological species is referred to as FMT (also termed fecal bacteriotherapy or stool transplant).

Psychiatric epidemiology of the elderly population in Chile.

Objectives: Little attention has been given to the prevalence rate of mental illness among elderly adults in Latin America. The prevalence rates for psychiatric disorders in Chile among those 65 and older compared with younger individuals, and the prevalence rate of psychiatric disorders among those age 75 and older are presented.

Design: A stratified random sample of 2,659 individuals.