Key features in the assessment of the elderly
The Aging page has been updated with a section outlining the key tasks in the assessment of the elderly.
Updates
Effect of stopping trials early
The Medical literature page has been updated with information about how stopping trials early due to a positive treatment effect usually overestimates the treatment effect.
tPA for lacunar strokes
The Thrombolytic therapy in stroke page has been updated with the removal of lacunar stroke from the list of stroke types unlikely to benefit from tPA following the publication of an IST-3 subgroup analysis.
tPA for stroke between 3-4.5 hours
Some additional information about the role of tPA in patients selected without advanced imaging (e.g. CT perfusion, DWI MRI) between 3-4.5 hours has been added to the Thrombolytic therapy in stroke page following the BMJ article published today that does not support the evidence for the use of tPA for this time window.
VRE
A new page called Drug resistant organisms has been created from the old Drug resistant Staph Aureus page and a short section on VRE has been added to it.
MINOCA
The section on Myocardial ischaemia and non-obstructive coronary arteries on the Coronary artery disease page has been updated with additional information regarding prognosis and causes.
Tetanus immunisation table
A table outlining the indications for tetanus toxoid and immunoglobulin has been added to the Wound management and Tetanus pages.
Surgery for #NOH
The Shoulder and arm region injuries page has been updated with additional information regarding the operative treatment of Neck of humerus fractures.
Clavicle fracture surgery review
The Shoulder and arm region injuries page has been updated with revised information regarding surgery for clavicular fractures based on the latest Cochran review of the subject.
BNP and NT-ProBNP test characteristics for heart failure
The Assessment of heart failure page has been updated with additional information regarding the test characteristics of BNP in the diagnosis of heart failure.
Sources of food poisoning
The Infective gastroenteritis page has been updated with additional information regarding the likely sources of various food borne pathogens.
Cancer induced bone pain
The Bone tumours page has been updated with additional information regarding the treatment of cancer induced bone pain.
Aortic dissection
The Thoracic aortic dissection page has been updated, particularly to update the test characteristics of modern CTA in the diagnosis.
Sterile pyuria
The Urinalysis page has been updated with a short segment on sterile pyuria.
Anthrax
Some minor additions have been made to the Anthrax and other pages relating to potential biological warfare agents following a review on the matter recently published in the NEJM.
Paediatric IV fluid calculator
A paediatric IV fluid calculator has been added to the Web features page.
Total body weight estimator
A total body weight estimator (using height and arm circumference) has been added to the Web features page.
Lean body weight estimator
A lean body weight estimator has been added to the Web features page.
IV steroids in severe CAP
The Management of CAP page has been updated with some information about the use of IV steroids in a selected population of patients with severe CAP. Bottom line is – sounds interesting, but not enough evidence currently to change practice.
Fusobacterium necrophorum pharyngitis
The Sore throat page has been updated with information about Fusobacterium necrophorum as a cause of pharyngitis.