1. Oral ketoconazole should never be used as
first-line therapy for any fungal infection because of the risk of liver
toxicity and interactions with other drugs as per FDA.
2.
Among patients presenting with an acute
stroke, women were less likely than men to receive intravenous
thrombolytic therapy, which could have to do with delayed arrival at the
hospital. In a cohort of patients presenting within 24 hours of stroke onset,
IV tissue plasminogen activator (tPA) was used in 11% of women and 14% of men
(OR 0.8, 95% CI 0.7-1.0), according to Inger de Ridder, MD, of Erasmus Medical
Center University Hospital in Rotterdam, and colleagues. In the subgroup of
patients who presented with an acute ischemic stroke within 4 hours of symptom
onset, however, the sex difference disappeared (41.6% versus 42.4%, OR 1.0, 95%
CI 0.8-1.2), the researchers reported online in Stroke:
Journal of the American Heart Association.
3.
There may be an early cognitive benefit for
dementia patients starting on
angiotensin-converting enzyme (ACE) inhibitors
for blood pressure control. Patients taking centrally active ACE inhibitors
experienced marginally slower rates of cognitive decline compared with those
not on the drugs according to William Molloy, MB, BCh, of the Centre for
Gerontology and Rehabilitation at the University College Cork, St. Finbarrs'
Hospital, in Cork City, Ireland, and colleagues in the online journal BMJ Open.
4.
In addition to reducing inappropriate antibiotic use and
providing better infection
control in outpatient settings, strategies to
control Clostridium difficile infection (CDI) should include
further examination of outpatient and household settings and a reduction in
proton pump inhibitor (PPI) use, according to an article published in
the July 22 issue of JAMA Internal Medicine.
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