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Friday, September 21, 2012

Do Human Lungs and Urinary Bladder Have a Normal Flora?

Hot off the press 09/28/2012:
Identification of microbes in healthy lungs sheds light on cystic fibrosis
Healthy people's lungs are home to a diverse community of microbes that differs markedly from the bacteria found in the lungs of cystic fibrosis patients. That's the result of new research from Stanford University and Lucile Packard Children's Hospital, which has wide implications for treatment of cystic fibrosis and other lung diseases. "The lung is not a sterile organ," said David Cornfield, MD, an author of the new study, which will be published Sept. 26 in Science Translational Medicine. Eurekalert!

Urinary Bladder Metagenome (PubMed)

Wolfe AJ, Toh E, Shibata N, Rong R, Kenton K, Fitzgerald M, Mueller ER, Schreckenberger P, Dong Q, Nelson DE, Brubaker L. J Clin Microbiol. 2012 Apr;50(4):1376-83. Epub 2012 Jan 25. PMID: 22278835 [PubMed - indexed for MEDLINE] Related citations



Lung Metagenome (PubMed)

Erb-Downward JR, Thompson DL, Han MK, Freeman CM, McCloskey L, Schmidt LA, Young VB, Toews GB, Curtis JL, Sundaram B, Martinez FJ, Huffnagle GB. PLoS One. 2011 Feb 22;6(2):e16384. PMID: 21364979 [PubMed - indexed for MEDLINE] Free PMC Article Related citations


Wednesday, September 12, 2012

Wednesday, September 5, 2012

Rotavirus Vaccines and Incidence of Intussusception


Transient, short segment intussusception
 is frequently seen on abdominal CT's.





Potential Intussusception Risk versus Benefits of Rotavirus Vaccination in the United States.
The burden of severe rotavirus disease averted due to vaccination compared with the vaccine-associated intussusception events offers a side-by-side analysis of the benefits and potential risks. If an intussusception risk similar to that seen internationally exists in the US, it is substantially exceeded by the benefits of rotavirus disease burden averted by vaccination. Desai R, Cortese MM, Meltzer MI, Shankar M, Tate JE, Yen C, Patel MM, Parashar UD. Pediatr Infect Dis J. 2012 Aug 27. [Epub ahead of print] PMID: 22929172

Wednesday, August 22, 2012

Transitioning from IV Infusion to SubQ Insulin in Diabetic Ketoacidosis

PubMed Search
((insulin OR "Insulin"[Mesh]) AND (diabetic ketoacidosis OR "Diabetic Ketoacidosis"[Mesh]) AND (subcutaneous insulin OR "Injections, Subcutaneous"[Mesh]) AND (intravenous insulin OR "Infusions, Intravenous"[MeSH Terms])) AND ( transition* OR guidelines OR guideline OR algorithms OR algorithm OR "Drug Administration Schedule"[MeSH Terms])

Hyperglycemic crises in adult patients with diabetes  (Google Scholar)
AE Kitabchi, GE Umpierrez, MB Murphy… - Diabetes …, 2006 - Am Diabetes Assoc ... Hyperglycemic Crises in Adult Patients With Diabetes. ... Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS) are the two most serious acute metabolic ... 8). Death in these conditions is rarely due to the metabolic complications of hyperglycemia or ketoacidosis ...
Cited by 154 - Related articles - BL Direct - All 23 versions
Above 154 citations narrowed by inclusion of terms: subcutaneous intravenous ketoacidosis insulin transition OR transitional OR transitioning OR guideline OR algorithm OR guidelines OR algorithms
Results: 43 citations

Hyperglycemic crises in adult patients with diabetes (Google Scholar)
AE Kitabchi, GE Umpierrez, MB Murphy… - Diabetes …, 2006 - Am Diabetes Assoc ... Hyperglycemic Crises in Adult Patients With Diabetes. ... Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS) are the two most serious acute metabolic ... 8). Death in these conditions is rarely due to the metabolic complications of hyperglycemia or ketoacidosis ...
Cited by 154 - Related articles - BL Direct - All 23 versions
Above 154 citations narrowed by inclusion of terms: subcutaneous ketoacidosis insulin OR algorithm OR algorithms
Results: 19 citations

Thursday, August 16, 2012

Gouty Arthritis

Since colchicine is anti-inflammatory is it considered a NSAID? (MeSH)
Colchicine is considered an alkaloid not a NSAID as seen  by their classification in the MeSH.  Scroll down the MeSH links to view the hierarchical classifications in the MeSH thesaurus.

Gouty Arthritis Reviews  (Pubmed)
Limits: English, Humans, Reviews

Timing the Initial Dose of Allopurinol (Pubmed)

Allopurinol and Organ Transplants (Pubmed)

Colchicine and Organ Transplantation (Pubmed)

Wednesday, July 25, 2012

Progestins as an Etiological Factor in Venous Thrombosis

Practice Guidelines (PubMed)

National Guideline Clearinghouse

Comparitive Studies (PubMed)

Meta-Analysis OR Systematic Reviews (PubMed)

Review from Past 5 Years (PubMed)

Progestins & IUD
In conclusion, progestogens may have differential effects on VTE risk according to the molecules and therefore represent an important potential determinant of the thrombotic risk among postmenopausal women using estrogens. Canonico M, Plu-Bureau G, Scarabin PY. Maturitas. 2011 Dec;70(4):354-60. Epub 2011 Oct 22. Review. PMID: 22024394

Assessing the risk of venous thromboembolic events in women taking progestin-only contraception: a meta-analysis
Published data assessing the risk of venous thromboembolism in women prescribed progestin-only contraception are limited. In this meta-analysis of eight observational studies, the use of progestin-only contraception was not associated with an increased risk of venous thromboembolism compared with non-users of hormonal contraception. The potential association between injectable progestins and thrombosis requires further study. Mantha S, Karp R, Raghavan V, Terrin N, Bauer KA, Zwicker JI. BMJ. 2012 Aug 7;345:e4944. PMID: 22872710 [PubMed - in process] PDF

Thursday, July 12, 2012

Cinnamon for Type 2 Diabetes

A PubMed search for Cinnamomum sp. and Type 2 Diabetes using Filters: Humans, Systematic Reviews, Meta-Analysis, English produced 7 results.  Most of the results confirmed a modest beneficial effect on FBG but no effect on HbA1c.

A systematic review and meta-analysis not yet indexed in PubMed concluded that the "use of cinnamon showed a beneficial effect on glycaemic control (both HbA1c and FPG) and the short term (<4 months) effects of the use of cinnamon on glycaemic control looks promising." (Cinnamon in glycaemic control: Systematic review and meta analysis. Akilen R, Tsiami A, Devendra D, Robinson N. Clin Nutr. 2012 May 12. [Epub ahead of print] PMID: 22579946)

Current Clinical Trials

Lexicomp

Natural Medicines Comprehensive Database


Coumarin is present in significant quantities (up to 1%) in  cassia cinnamon (Cinnamomum aromaticum).  Coumarin has shown hepatotoxic effects in animal models.   Although only somewhat dangerous to humans, coumarin is a potent rodenticide: Rats and other rodents metabolize it largely to 3,4-coumarin epoxide, a toxic compound that can cause internal hemorrhage and death. Humans metabolize it largely to 7-hydroxycoumarin, a compound of lower toxicity. [1]


The Natural Medicine Comprehensive Database Registration
Then chose first time user and create and account.  


1. Relative bioavailability of coumarin from cinnamon and cinnamon-containing foods compared to isolated coumarin: a four-way crossover study in human volunteers. Abraham K, Pfister M, Wöhrlin F, Lampen A. Mol Nutr Food Res. 2011 Apr;55(4):644-53. Epub 2010 Dec 20. PMID: 21462332

Thursday, June 28, 2012

Ultrasound Guided Lumbar Puncture

Lumbar relaxed from ACEP
CME From ACEP

MedScape

NEJM Video
(Practice signing in with Athens)

Lumbar curled from ACEP
PubMed articles
Broad search

Narrow search

Pre-indexed (hot off the press)

Google Scholar (drilling-up)
Diagnostic and interventional ultrasonography in neonatal and infant lumbar puncture.
Coley BD, Shiels WE 2nd, Hogan MJ.)
Pediatr Radiol. 2001 Jun;31(6):399-402.)
PMID: 11436885 [PubMed - indexed for MEDLINE] )
Related citations (PubMed)
Cited by (Google Scholar)