Oldest Patient ‘Cured’ of HIV Still in Remission 5 Years After Transplant for AML
A 68-year-old man with HIV-1 who underwent hematopoietic cell transplant (HCT) for acute myelogenous leukemia 5 years ago has been free of HIV infection for 35 months after stopping antiretroviral treatment (ART), according to a case report. The patient received an HCT from a donor with the rare delta-32 mutation, which causes a CCR5 deletion […]
Before Stroke Thrombectomy, Keep the Bed Flat, Trial Says
PHOENIX — For large vessel occlusion (LVO) acute ischemic stroke patients planned for mechanical thrombectomy, bed positioning made a big difference in clinical worsening, the ZODIAC trial showed. Keeping the head of the bed flat at a zero-degree angle after the CT scan while awaiting the cath lab led to 50-fold fewer cases of early […]
CDC: Biennial Surge in Acute Flaccid Myelitis Has Come to a Halt
Acute flaccid myelitis (AFM) cases remained low in 2022, despite increased circulation of the enterovirus D68 (EV-D68) in the U.S., according to an analysis of CDC data. AFM cases ranged from 28 to 47 per year from 2019 to 2022 — far lower than the 238 confirmed cases in 2018, Sarah Kidd, MD, from the […]
Prone Positioning Falls Flat for Weaning COVID Patients Off ECMO
Early application of prone positioning did not help patients with severe acute respiratory distress syndrome (ARDS) — mostly from COVID — get off venovenous extracorporeal membrane oxygenation (VV-ECMO) any faster compared to supine positioning, a randomized trial found. Among ARDS patients receiving ECMO, an identical 44% of patients were successfully weaned off ECMO after 60 […]
Convalescent Plasma Improves Survival in COVID Patients with ARDS, New Trial Shows
Convalescent plasma reduced mortality in COVID-19 patients with acute respiratory distress syndrome (ARDS) when provided within 5 days of invasive mechanical ventilation, the randomized open-label CONFIDENT trial showed. Mortality at 28 days was 35.4% among patients who received donated convalescent plasma with at least 1:160 neutralizing antibody titer, compared with 45% in patients who received […]
Amoxicillin Alone for Acute Sinusitis Holds Up Against Broad-Spectrum Cousin
Treatment failure with amoxicillin-clavulanate for pediatric acute sinusitis was similar compared with amoxicillin alone, but the broad-spectrum antibiotic may be associated with more adverse events, an examination of a large commercial claims database revealed. The two frequently prescribed antibiotics were similar in their risk for treatment failure (1.7% with amoxicillin-clavulanate vs 1.8% with amoxicillin; RR […]
Complete PCI Better for Older MI Patients Too
AMSTERDAM — Complete revascularization improved outcomes over culprit-lesion-only stenting in older acute myocardial infarction (MI) patients, the FIRE trial affirmed. Among a population ages 75 and older, the composite risk of death, MI, stroke, or any revascularization came out a relative 27% less common when addressing all the stenosed vessels during the same hospitalization (15.7% […]
Recreational Drug Use More Common in Intensive Cardiac Care Than Many Admit
Many recreational drug users suffering acute cardiovascular events ended up in cardiac intensive care units (ICUs) without disclosing their drug use, according to the ADDICT-ICCU study conducted across France. The incidence of a positive drug screen was 11% among 1,499 consecutive patients admitted for acute cardiovascular events, with systematic urine testing revealing use of cannabis […]
Surveillance Still Not an Option for Many With Subsegmental Pulmonary Embolism
Only a narrow pool of outpatients with acute subsegmental pulmonary embolism (PE) may be candidates for structured surveillance without anticoagulation based on current guideline restrictions, a retrospective study found. At one large integrated health system, only one person out of 229 low-risk adults received structured surveillance for subsegmental PE — a “remarkably low” 0.4% over […]
Antidepressant Maintenance No Help for Bipolar I Depressive Episode
Continuing adjunctive antidepressant treatment for up to a year following remission of an acute depressive episode in patients with bipolar I disorder showed no significant benefit for preventing relapse, a randomized trial showed. At 52 weeks, 31% of patients treated with maintenance escitalopram (Lexapro) or bupropion XL (Wellbutrin XL) for that duration of time experienced […]