Cefepime-Induced Neurotoxicity

By Martina McGrath, MD
February 20, 2018

Cefepime is a fourth generation cephalosporin with extended spectrum of coverage, including gram-positive and gram-negative organisms, such as Klebsiella pneumoniae, Pseudomonas aeruginosa, Citrobacter and Serratia.1 It has activity against many multidrug-resistant gram negatives and is resistant to beta lactamases. Given its broad range of activity, it is a widely used and highly effective choice for hospitalized patients with a range of infections.

However, at elevated concentrations, cefepime can cross the blood-brain barrier Continue reading “Cefepime-Induced Neurotoxicity”

Assessing the Risks in Live Kidney Donation

By Martina McGrath, MD
February 13, 2018

Kidney transplantation is a life-saving procedure and is associated with at least a doubling in life expectancy of transplant recipients.1 Live-donor kidneys provide better kidney function and longer transplant survival than those from deceased donors. However, live donation is not entirely without risk, Continue reading “Assessing the Risks in Live Kidney Donation”

Type 1 Diabetes: Not Just a Disease of the Young

By Connor Emdin
January 30, 2018

Type 1 diabetes (T1D) is commonly thought of as a disease of children and young adults, with a peak age of diagnosis around 14 years.1 However, adults with T1D may be misdiagnosed as having type 2 diabetes (T2D) due to the much greater prevalence of T2D in older ages.2 Such misdiagnosis of T1D as T2D may have important clinical consequences. Individuals with undiagnosed T1D may be less likely to receive insulin therapy and may present with diabetic ketoacidosis, a life-threatening emergency characterized by elevated blood glucose and ketone levels.3 Continue reading “Type 1 Diabetes: Not Just a Disease of the Young”

Mortality Prediction in Community-Acquired Pneumonia: The end of the road for SIRS?

By Martina McGrath, MD
December 19, 2017

In 2016, new consensus guidelines were issued for the clinical criteria for sepsis.1 The qSOFA score, incorporating tachypnea, low blood pressure and altered mental status, was proposed as a rapid, bedside assessment, and an alternative to SIRS criteria, to identify patients at high risk of adverse outcomes. Continue reading “Mortality Prediction in Community-Acquired Pneumonia: The end of the road for SIRS?”

Ibuprofen and Acetaminophen Combo As Effective as Opioid Analgesia for Acute Pain

By Martina McGrath, MD
November 9, 2017

The opioid epidemic is the preeminent public health crisis facing the US today. In recent days, the CDC has reported that opioid overdose deaths rose by 17% in 2016, and the annual rate of fatal overdose deaths now stands at 20 per 100,000 people.1

While multiple factors have been implicated in driving the epidemic, Continue reading “Ibuprofen and Acetaminophen Combo As Effective as Opioid Analgesia for Acute Pain”

Oxygen in Acute MI: Lack of Benefit and Possible Risk?

By Martina McGrath, MD
November 3, 2017

Acute myocardial infarction occurs where there is insufficient supply of oxygenated blood to an area of the heart, leading to myocardial injury and cell death. For decades, clinical guidelines have recommended the administration of supplemental oxygen as a first-line therapy for all patients experiencing myocardial ischemia, regardless of oxygen saturation.1 Continue reading “Oxygen in Acute MI: Lack of Benefit and Possible Risk?”