Archive for category: Infectious Disease

APROCCHSS: More on Steroids in Septic Shock

29 Mar
March 29, 2018

Background: There have now been several trials published on the use of steroids in sepsis.  In 2002, we had the Annane Trial, with 299 patients showing mortality and shock reversal benefit in sepsis with hydrocortisone.  Then in 2008 we had the CORTICUS trial, with 499 patients, which found a faster reversal of shock, but no […]

The ADRENAL Trial: Steroids in Septic Shock

22 Jan
January 22, 2018

Background: Randomized clinical trials evaluating the efficacy of adjunctive corticosteroids in septic shock have shown conflicting evidence of clinical relevance. Two trials in particular [2][3] looked at lower dose hydrocortisone (200mg/day) and its effect on mortality in patients with septic shock resulting in conflicting results in regards to mortality, but both showing earlier reversal of […]

Should we Pump up the Juice (Steroids) in Septic Shock?

18 Jan
January 18, 2018

Background: A Cochrane review was published in 2015 evaluating 33 trials with 4,268 participants to evaluate the effects of corticosteroids on death at one month in patients with sepsis.  In that meta-analysis the authors concluded that despite the overall low quality of evidence, corticosteroids still reduced mortality among patients with sepsis. Corticosteroids in sepsis/septic shock […]

Bacterial Endocarditis

04 Dec
December 4, 2017

Background: Definition Infective Endocarditis (IE) = Inflammation of the endothelium of the heart, heart valves (or both) (Osman 2013) Epidemiology Annual incidence = 5-7 cases per 100,000 (Fraimow 2013) 40,000 to 50,000 new cases in the US per year. Average hospital charges in excess of $120,000 per patient (Bor 2013) Slightly higher male predominance (1.5:1 […]

REBEL Cast Episode 42: Research From the Past Year – In the Pipeline

13 Nov
November 13, 2017

Welcome back to Episode 42 of REBEL Cast. In this episode, we will be discussing some studies from the past year that had some interesting results and a couple of papers that are potentially going to change our practice in the near future (In the Pipeline). Again, this 3 part series will be dedicated to […]

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