Limited observational data have suggested that amantadine, an indirect dopamine agonist and N-methyl-D-aspartate antagonist, may have favorable neurobehavioral effects for patients with severe traumatic brain injury (TBI). The favorable effects may be due to enhanced neurotransmission during a period of dopamine depletion and neuronal hypoexcitability following brain injury. In the March issue of  The New […]

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As our understanding of the coagulation cascade evolves, intensivists have sought ways to manipulate the pathway to attenuate the effects of hemorrhagic shock. Tranexamic acid (TXA) is a lysine analog that binds the plasminogen molecule, inhibiting fibrinolysis. In the February issue of Archives of Surgery, Morrison et al report their experience in the use of […]

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The amount of artificial nutrition required to optimize outcomes in patients with acute lung injury (ALI) is unknown. To address this problem, the Acute Respiratory Distress Syndrome (ARDS) Clinical Trials Network, headed by Todd Rice, MD, MS, from VanderbiltUniversityinNashville,Tennessee,USA, conducted a prospective, randomized open-label trial comparing the effect of initial trophic enteral feeding vs. initial […]

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Despite advances in mechanical ventilation and critical care, the mortality rate for acute respiratory distress syndrome (ARDS) remains over 40%. In addition to mortality, health-related quality of life (HRQL) is also thought to be impacted negatively. Prone positioning has been used in ARDS to attenuate lung injury and to provide a more homogeneous distribution of […]

Enterococci are an increasingly common cause of urinary tract infections (UTI) and asymptomatic bacteriuria (ABU) in hospitalized patients. Despite the publication of guidelines for appropriate antibiotic use, many patients are inappropriately prescribed antimicrobials for ABU. In this month’s issue of Archives of Internal Medicine, Lin et al conducted a retrospective medical record review from two […]

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