Dunn RJ
Some additional information about the test characteristics of CT chest for the diagnosis of CAP has been added to the Community acquired pneumonia page. Claessens, Y-E, Debray, M-P, Tubach, F, et al. Early Chest Computed Tomography Scan to Assist Diagnosis and Guide Treatment Decision for Suspected Community-acquired Pneumonia. American Journal of Respiratory and Critical Care … Read more
The Pulmonary embolism page has been updated so the investigation of patients with intermediate risk PE is now the same as those with low risk for PE.
The section on the ECG findings in PE on the Investigations in PE – non imaging page has been revised considering the information from the following article: Shopp, JD, Stewart, LK, Emmett, TW, et al. Findings From 12-lead Electrocardiography That Predict Circulatory Shock From Pulmonary Embolism: Systematic Review and Meta-analysis. Acad Emerg Med 2015;22(10):1127-37. http://www.ncbi.nlm.nih.gov/pubmed/26394330.
The table on the Pulmonary embolism page previously called Simplified Well’s score was actually just the original Well’s score. This has been corrected in the online version however not in the first 3 print runs of the print version.
The Well’s and Geneva scores, and their simplified versions, have been simplified into 2 tables – including the risk stratification cut offs for each of them. This can be found on the Pulmonary embolism page.
The Management of CAP page has been updated with information about the beneficial role of steroids in hospitalised patients with severe CAP. Siemieniuk, RAC, Meade, MO, Alonso-Coello, P, et al. Corticosteroid Therapy for Patients Hospitalized With Community-Acquired Pneumonia. A Systematic Review and Meta-analysis. Annals of Internal Medicine 2015.
The Assessment of COPD page has been updated with the new 2015 GOLD spirometric assessment of severity data. Thanks to Dan Anderson for the tipoff about the changes – thanks Dan!
The PE in special populations page has been updated with particular reference to d dimer levels during pregnancy. Some relevant references are: Greer, IA. Pregnancy Complicated by Venous Thrombosis. New England Journal of Medicine 2015;373(6):540-47. http://www.nejm.org/doi/full/10.1056/NEJMcp1407434. Kline, JA, Williams, GW, Hernandez-Nino, J. D-dimer concentrations in normal pregnancy: new diagnostic thresholds are needed. Clin Chem 2005;51(5):825-9. … Read more
The Long term management of asthma page has been updated with some information about the role of lebrikizumab.
CXR images and a small segment on pericardial cysts have been added to the Mediastinal masses page.
Some additional information about the accuracy of US for the diagnosis of pneumonia has been added to the Community acquired pneumonia page.
Additional information about describing abnormalities on the CXR have been added to the Chest imaging page.
Short segments on the significance of rotation and patient position on the CXR have been added to the Chest imaging page.
An US image demonstrating the stratosphere sign of pneumothorax has been added to the Assessment of pneumothorax page.
Additional information about securing and attaching an ICC to an UWSD has been added to the Management of pneumothorax page.
Additional information about anaesthetising the pleura prior to insertion of an ICC has been added to the Management of pneumothorax page.
Additional information about Heimlich valves has been added to the Management of pneumothorax page.
An image of a pigtail pleural catheter has been added to the Management of pneumothorax page.
Some additional information about consent for pneumothorax drainage has been added to the Management of pneumothorax page.
The Management of CAP page has been updated with some information about the use of IV steroids in a selected population of patients with severe CAP. Bottom line is – sounds interesting, but not enough evidence currently to change practice.