2009 The Acetaminophen Hepototoxicity Working Group, FDA

An FDA advisory committee will convene in late June to consider the report submitted by The Acetaminophen Hepatotoxicity Working Group, Center for Drug Evaluation and Research, Food and Drug Administration, Department of Health and Human Services, on February 26, 2008.
Editor's notes: Acetaminophen is paracetamol (panadol). For the 500mg tablets in Hong Kong, it means that the maximum dose is suggested to be around 2 tabs tds (3000 mg) instead of 2 tabs QID (4000 mg). The comments are about over-the-counter acetaminophen, but the dosage recommendations may still apply to critically ill patients. Please comment.

The working group's report, released online Wednesday 27 May 2009, is summarised below. For over-the-counter acetaminophen, the working group recommends, among other actions:

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2009 甲型H1N1流感密切接触者隔离医学观察简明指引 (试行)

作者:厅应急办 来源:广东省卫生厅 2009年5月4日


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2009 卫生部办公厅关于印发《人感染猪流感诊疗方案(2009版)》的通知

卫生部办公厅, 二〇〇九年四月二十九日



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2009 关于印发广东省流感大流行卫生应急预案(试行)的通知

作者:厅应急办   来源:广东省卫生厅   广东省卫生厅 2009年5月1日

联系人:伍岳琦    联系电话:020-83710166



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Submitted by Dr LAU Chun Wing Arthur, Editor-in-Chief, 2100 1 May 2009



The Chief Executive of the Hong Kong SAR, Mr Donald Tsang, announced that the first case of influenza A H1N1 (previously called swine flu) has been identified in Hong Kong.

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2009 College of Intensive Care Medicine of Australia and New Zealand

From the beginning of 2010 this newly incorporated body will assume responsibility for the training and certification of medical practitioners (Intensive Care Physicians) and standards in the field of intensive care medicine in this region.

The new body, which will be based in Melbourne, will take over the training program from the existing Joint Faculty of Intensive Care Medicine (JFICM), which was formed in 2002 as part of both the Royal Australasian College of Physicians (RACP) and the Australian and New Zealand College of Anaesthetists (ANZCA). The new college will be based on a proud heritage of intensive care medicine in Australia and New Zealand, dating from the first postgraduate program and examinations in intensive care medicine in the world in 1979.

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2009 US FDA: Ceftriaxone and calcium-containing products may be used concomitantly in patients >28 days of age

FDA 14 April 2009

FDA notified healthcare professionals of an update to a previous alert that addresses the interaction of ceftriaxone with calcium-containing products, based on previously reported fatal cases in neonates. At the request of FDA, the manufacturer of ceftriaxone (Roche) conducted two in vitro studies to assess the potential for precipitation of ceftriaxone-calcium when ceftriaxone and calcium-containing products are mixed in vials and in infusion lines. These two in vitro studies were conducted in neonatal and adult plasma to assess the potential for precipitation of ceftriaxone-calcium using varying ceftriaxone and calcium concentrations, including concentrations in excess of those achieved in vivo.

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2009 Critical illness rehabilitation: NICE guideline

Rehabilitation after critical illness was one of the lectures during the opening ceremony of the 29th International Symposium on Intensive Care & Emergency Medicine (ISICEM) in Brussels.
nhs logo

A guideline has been published in conjunction with the lecture.

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2009 New IDSA guidelines provide updated recommendations for treating patients who have or are at risk for Candida infections

Pappas PG, Kauffman CA, Andes D, Benjamin DK, Calandra TF, Edwards JE, et al; Infectious Diseases Society of America.

Clin Infect Dis. 2009 Mar 1;48(5):503-35.

Department of Medicine, Division of Infectious Diseases, University of Alabama at
Birmingham, Birmingham, Alabama 35294-0006, USA. This email address is being protected from spambots. You need JavaScript enabled to view it.

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2009 A Tactic to Cut I.C.U. Trauma: Get Patients Up

Published: January 11, 2009
For years, doctors thought they had done their jobs if patients came out of an intensive care unit alive.
Now, though, researchers say they are alarmed by what they are finding as they track patients for months or years after an I.C.U. stay. Patients, even young ones, can be weak for years. Some have difficulty thinking and concentrating or have post-traumatic stress disorder and terrible memories of nightmares they had while heavily sedated.
Read more here.

2008 Health Care That Puts a Computer on the Team

New York Times
Published: December 26, 2008

... To visit the Marshfield Clinic, a longtime innovator in health information technology, is to glimpse medicine’s digital future. Across the national spectrum of health care politics there is broad agreement that moving patient records into the computer age, the way Marshfield and some other health systems have already done, is essential to improving care and curbing costs. ...

Read more at http://www.nytimes.com/2008/12/27/business/27record.html

2008 For Patients, More Comfort and a Bigger Dose of Respect

New York Times
Published: February 17, 2008

... There is also increasing recognition that hospitals might be nearly as traumatic for family members as they are for patients. More flexibility and support for visitors can help. The intensive care unit once strictly limited visitors’ access; now a family member can get a sleeper chair in the room. Even if a patient is facing a life-threatening situation, loved ones are not shooed away.

Read more at http://www.nytimes.com/2008/02/17/nyregion/nyregionspecial2/17hospitalswe.html?scp=16&sq=intensive%20care%20unit&st=cse

2008 City Pushes Cooling Therapy for Cardiac Arrest


Published: December 3, 2008

Starting on Jan. 1, New York City ambulances will take many cardiac arrest patients only to hospitals that use a delicate cooling therapy believed to reduce the chances of brain damage and increase the chances of survival, even if it means bypassing closer emergency rooms.

Read more at http://www.nytimes.com/2008/12/04/nyregion/04cool.html?scp=9&sq=intensive%20care%20unit&st=cse


2008 The Lab Says Heart Attack, but the Patient Is Fine

New York Times

Published: November 26, 2008

THE man was 40 years old and seemed perfectly healthy — he had just run a 10-kilometer race. But he fainted after the race and was rushed to a hospital. There, in the emergency room, his blood was tested. His levels of a heart protein, troponin, were sky-high. It looked as if he was having a heart attack.

The runner ended up in the coronary intensive care unit at Hadassah-Hebrew University Medical Center in Jerusalem.

Read more at http://www.nytimes.com/2008/11/27/health/nutrition/27best.html?scp=7&sq=intensive%20care%20unit&st=cse



2008 In Hospitals, Simple Reminders Reduce Deadly Infections

New York Times

Published: May 19, 2008

... In late 2005, the city’s Health and Hospitals Corporation adopted a series of simple, standardized protocols based on those developed by Dr. Peter J. Pronovost, a crusader against preventable hospital deaths and a professor of anesthesiology and critical care medicine at Johns Hopkins University. Dr. Pronovost calls his protocols a checklist, and that is pretty much what they are.

Read more at http://www.nytimes.com/2008/05/19/nyregion/19hospital.html?scp=6&sq=intensive%20care%20unit&st=cse

2008 The Six Habits of Highly Respectful Physicians

Published: December 1, 2008

.... In the article, I described a common-sense method for spreading clinical courtesy that I call “etiquette-based medicine,” and I proposed a simple six-step checklist for doctors to follow when meeting a hospitalized patient for the first time: ...


1. Ask permission to enter the room; wait for an answer.

2. Introduce yourself, showing ID badge.

3. Shake hands (wear glove if needed).

4. Sit down. Smile if appropriate.

5. Briefly explain your role on the team.

6. Ask the patient how he or she is feeling about being in the hospital.


Read more at: http://www.nytimes.com/2008/12/02/health/02etiq.html?_r=1&ref=health

Also read the original article in NEJM: Michael W. Kahn, M.D. NEJM. Volume 358:1988-1989 May 8, 2008 Number 19