Special Considerations in Elderly Patients With Chronic Obstructive Pulmonary Disease

一整個讓人充滿疑問的結果......

The risk for Guillain-Barré syndrome is not increased after use of adjuvanted pandemic influenza (H1N1) 2009 vaccine, but the upper limit does not exclude a potential increase in risk up to 2.7-fold, according to the results of a multinational case-control study reported online July 12 in the BMJ.

急性外耳炎，又名游泳耳，指的在耳膜以外到耳殼之間發炎。 門診常看到病人抱怨，耳朵痛、外耳道腫脹或造成聽力障礙，甚至嘴巴一張開就會疼痛的情形。

好發於濕熱的夏季，因為游泳後(或挖耳不當)，如產生下列症狀時，如：耳朵發癢、被異物塞住的感覺、轉動頭部或拉耳朵時耳朵感到疼痛或聲音聽不清楚時，便可能得到外耳炎。

Question

Why is swimmer's ear so common in the summer months, and how should it be managed in primary care?

Nancy H. Hope, PharmD

Question:

Can an amiodarone drip be converted to twice-daily IV bolus dosing if the patient is unable to take anything by mouth or nasogastric tube?

FDA表示，根據大型隨機分派研究結果，使用ESA可能增加心血管疾病風險，他們的建議是:

- 尚未接受透析的CKD患者: 僅當血紅素低於10 g/dl時才考慮開始使用ESA，如果治療後血紅素超過10 g/dl，應該考慮減少或暫停使用ESA (很硬!)

- 已經接受透析的CKD患者: 當血紅素低於10 g/dl時開始使用ESA，如果治療後血紅素超過11 g/dl，應該考慮減少或暫停使用ESA

在FDA的聲明中表示，仿單中移除了之前治療目標 (target) 的概念 (因為會讓人聯想這樣才會有效)，而改採治療建議

The US Food and Drug Administration (FDA) today urged more conservative dosing guidelines for erythropoiesis-stimulating agents (ESAs) when used to treat anemia in patients with chronic kidney disease (CKD).

The US Food and Drug Administration (FDA) has approved fentanyl nasal spray (Lazanda) for the management of breakthrough pain in adults with cancer. It is indicated for patients aged 18 years and older who are already receiving opioid therapy but who have developed resistance to their regimen.

Ann Intern Med.  2011; 154(8):529-40 (ISSN: 1539-3704)

Ruxolitinib：a selective JAK1 and JAK2 inhibitor

Patients with ulcer bleeding who have failed endoscopic hemostasis gain relief from transarterial embolization (TAE). The procedure leads to fewer surgeries, has fewer associated complications, and does not increase overall mortality, according to a study published in the May issue of Gastrointestinal Endoscopy.

Aspirin and simvastatin, which have been shown to be beneficial in the treatment of cardiovascular disease, are ineffective at improving functional capacity in patients with pulmonary arterial hypertension (PAH), according to a multicenter study, sponsored by the National Institutes of Health (NIH), presented here at the American Thoracic Society 2011 International Conference.

The following test-and-teach case makes up an educational activity modeled on the interactive grand rounds approach. The questions within the case are designed to test your current (ie, baseline) knowledge. After each question, you will be able to see whether you answered correctly and can then read evidence-based information that supports the most appropriate answer choice. Please note that these questions are designed to challenge you; you will not be penalized for answering the questions incorrectly. At the end of the activity, there will be a short post-test assessment based on material covered in the case.

During the second and third trimester of pregnancy, sulfonamides and nitrofurantoins may be used as first-line agents for urinary tract and other infections, but in the first trimester, these agents may be used when no alternatives are available, according to a Committee Opinion from the American College of Obstetricians and Gynecologists (ACOG).

The US Food and Drug Administration has issued an alert about medication error reports in which patients were mistakenly given the antipsychotic risperidone (Risperdal, Johnson & Johnson) instead of the dopamine agonist ropinirole (Requip, GlaxoSmithKline) and vice versa.

Gradual increases in dietary calcium intake above the first quintile in a large female cohort are not associated with further reductions in fracture risk or osteoporosis, according to the results of a prospective longitudinal cohort study reported in the May 24 issue of the BMJ.

 For patients with chronic obstructive pulmonary disease (COPD), prior use of inhaled corticosteroids (ICS) is associated with a lower risk for short-term mortality and lower use of mechanical ventilation after hospitalization for pneumonia, according to the results of a retrospective database analysis reported online April 15 in the American Journal of Respiratory and Critical Care Medicine.

Introduction

Proton pump inhibitors (PPIs) are ineffective in reducing gastroesophageal reflux disease (GERD) symptoms in infants, and placebo-controlled trials in older children are lacking, according to the results of a systematic review reported online April 4 and will appear in the May print issue of Pediatrics.

The American College of Rheumatology (ACR) discusses treatment options for juvenile idiopathic arthritis (JIA) and puts forth a set of recommendations intended to help clinicians navigate the data related to initiating and monitoring drug treatment. The recommendations appear in the April issue of Arthritis Care & Research and were endorsed by the Arthritis Foundation.

The US Food and Drug Administration (FDA) has approved the use of 3.75% imiquimod cream (Zyclara Cream) for the treatment of external anogenital warts in people aged 12 years and older, according to an announcement released by Graceway Pharmaceuticals, which manufactures the cream.

S. Andrew Josephson, MD