Student Nurse's Station

By John Gever, Senior Editor, MedPage Today Published: March 24, 2010 Reviewed by Dori F. Zaleznik, MD; Associate Clinical Professor of Medicine, Harvard Medical School, Boston and Dorothy Caputo, MA, RN, BC-ADM, CDE, Nurse Planner Atypical femoral fractures in patients with osteoporosis were extremely rare and not significantly more common with bisphosphonates, results of a meta-analysis showed. Among more than 14,000 patients involved in three large randomized trials, only 12 fractures of the subtrochanteric or diaphyseal femur were recorded, Dennis Black, PhD, of the University of California San Francisco, and colleagues reported online in the New England Journal of Medicine. The investigators looked at data from the Fracture Intervention Trial (FIT) and its five-year extension, which compared alendronate (Fosamax) to placebo, and the HORIZON Pivotal Fracture Trial, which tested zoledronic acid (Reclast). They reported the following relative risks for subtrochanteric or d...

Steroids Offer No Help for Pneumonia By John Gever, Senior Editor, MedPage Today Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco and Dorothy Caputo, MA, RN, BC-ADM, CDE, Nurse Planner Earn CME/CE credit for reading medical news Action Points * Explain to interested patients that corticosteroids are used to reduce inflammation, which is a prominent feature of many infections including pneumonia. * Explain that some previous studies had suggested a benefit for corticosteroids in pneumonia but the evidence was not strong. But this relatively large randomized trial, a strong form of evidence, showed that corticosteroids provided no benefit in most cases, and may have fostered recurrence of pneumonia in some. * Explain that some patients may nevertheless benefit from corticosteroids despite the findings of this study. Treatments must be determined for each patient individually. Adding prednisolone to antibiotic...