Publication Of New Guidelines Research Articles

Air ou oxygène pour le nouveau-né en salle de naissance ?

Most of the contemporary guidelines on newborn resuscitation are based on experience but lack scientific evidence. The use of 100% oxygen is one of the more evident. Today, these practices are questioned, particularly for the resuscitation of moderately depressed full term or near term newborns. Results of recent meta-analysis of trials that compared ventilation with air versus pure oxygen at birth suggests current practices should be revisited. On the basis of these data, air can be the initial gas to use for these babies. Large scale trials, including preterm and cause and/or severity of initial asphyxia, must now be undertaken before the publication of new guidelines for these populations. Particularly severely asphyxiated infants might require supplemental oxygen with titration of oxygen delivery and continuous monitoring of oxygen saturation.

Recent Developments in the Management of Herpes Simplex Virus Infection in HIV‐Infected Persons

Herpes simplex virus (HSV) and HIV have certain common features, including persistence, stigma, and treatment that effectively decreases viral replication but cannot achieve cure. There has been continuing interest in these 2 viruses and their interrelationship since disease caused by HIV was first reported in 1981 and acyclovir was approved by the US Food and Drug Administration in 1982. At one time, it was thought that acyclovir might be useful in treatment of HIV infection because of evidence that it slowed disease progression [1], an observation that is now hypothesized to be attributable to suppression of CD4 + cell activation by persistent HSV coinfection. Views of the relationship between HIV and HSV have now taken a different direction, but one that has substantial support in clinical observations and biology, the importance of HSV in facilitating HIV transmission. This comes at a time of renewed attention to prevention of HIV infection, with the publication of new guidelines from the US Public Health Service [2], although the specific issue of HSV coinfection is barely mentioned. Management of HSV is particularly important in HIV-positive persons, who may experience severe and prolonged outbreaks. Recurrences may be more frequent or chronic and may become nearly continuous as immunosuppression progresses. Episodic or suppressive therapy with oral antiviral agents is often beneficial in the management of HSV disease in HIV-infected persons [3]. Acyclovir, famciclovir, and valacyclovir suppressive therapy have all been studied in HIVimmunocompromised persons [4‐6]. The newer antiviral agents offer increased convenience over acyclovir, and valacyclovir may offer superior efficacy, compared with acyclovir [7]. The choice of treatment regimen is subjective and may be driven by cost, frequency and severity of the HSV outbreak, and patient preference for episodic or (daily) suppressive therapy. One of the most important studies relevant to the role of HSV in HIV trans

The power of statins: aggressive lipid lowering.

The publication of new guidelines from the National Cholesterol Education Program poses new challenges for clinicians in terms of assessing risk and determining treatment strategies for individual patients. It is clear from accumulated epidemiologic data that lowering low-density lipoprotein cholesterol is a key element in the quest for cardiovascular health. In the past, choices for pharmacotherapeutic intervention were limited by issues of tolerance and, therefore, patient compliance. Fortunately, the statin class of drugs offer lipid lowering with both good safety and tolerability.