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These data suggest that CT could replace bronchoscopy as the first-line procedure for screening patients with large and those with massive hemoptysis. However, these results must be confirmed in a prospective multicenter study.

Endocavitary ultrasound probes may carry pathogens after removal of covers under routine conditions. A disinfection procedure consisting of cleaning with a disinfectant-impregnated towel followed by disinfection with UVC may provide a useful method for disinfecting endocavitary ultrasound probes.

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Kingella kingae is a fastidious gram-negative bacillus that is considered an emerging pathogen in pediatric settings but remains less common in adults. Here we describe a case of pericarditis in an immunocompetent adult host. The microorganism was identified directly from the clinical sample by molecular techniques, i.e., 16S rRNA gene amplification and sequencing. CASE REPORTIn December 2006, a 43-year-old woman was admitted to our hospital for dyspnea and fever. The patient had no significant medical history. A week before admission, she had complained of fever with a sore throat and was treated with 1 g of amoxicillin (three times a day) for 5 days without improvement. She was then admitted for dyspnea. The clinical exam was unremarkable except for a temperature of 38.2°C and reduced breath sounds in the left lung base. The leukocyte count was 16,300/mm 3 (absolute neutrophil count, 11,200/mm 3 ), and the hemoglobin level was 10 g/dl. The C-reactive protein (CRP) was markedly elevated at 308 mg/ liter (normal level, Ͻ10 mg/liter), and the liver enzyme levels were twice the normal range. The patient was hypoxic, with an arterial partial pressure of oxygen equal to 59 mm Hg. A chest X-ray showed enlargement of the cardiac silhouette, and an elevation of the ST segment (the time between the end of the ventricle's depolarization and the beginning of repolarization) compatible with pericarditis was noted on the electrocardiogram. Transthoracic echocardiography was rapidly performed and revealed a circumferential pericardial effusion with tamponade.

1 Losartan (DuP 753, MK-954) is a novel, potent and highly selective AT1angiotensin II receptor antagonist. The effect of multiple oral doses of losartan on digoxin pharmacokinetics was evaluated in healthy male subjects. 2 In a double-blind and randomized fashion, subjects received 50 mg losartan or placebo once daily for 15 days in each period. At least 7 days elapsed between the two treatment periods. On days 4 and 11 of each period, subjects also received a single 0.5 mg dose of digoxin intravenously and orally respectively. 3 Eleven of 13 subjects completed the study. Side effects were mild and transient (12 out of 13 subjects reported at least one adverse experience). During the study, no laboratory abnormalities were noted. 4 Multiple oral doses of losartan (50 mg

As the prevalence of PE increases with age, the effect of age on the diagnostic work-up in front of a clinical suspicion of PE deserves exploration. In this retrospective analysis, we used the data from 1041 consecutive suspected PE patients. The patients were divided into three groups according to tertiles of age: under 54 years, 54 to 73 years and above 73 years. The prevalence of PE in patients with respectively low, intermediate and high pretest clinical probability was expressed within each age group. We studied the effect of age on the results observed in three main groups of patients, after performing CT scan and ultrasonography (CUS): (1) patients with inconclusive results; (2) patients with negative findings on both exams and non high pretest clinical probability; (3) patients with positive findings.The prevalence of PE increased significantly with age, in overall, as well as in patients with low or intermediate pretest clinical probability. An analysis according to the three main diagnostic groups showed that: (1) the distribution of inconclusive spiral CT or CUS examinations was not different between age groups; (2) no thromboembolic event occurred in untreated patients with low or intermediate clinical probability aged under 54 years of age, whereas 7 events were diagnosed in patients aged over 73 years (p<0.001); (3) a higher proportion of older patients had a positive result at both spiral CT and CUS examinations. The percentage of positive CT scans in the case of negative or inconclusive CUS results was not different between age groups; conversely, in the case of a negative or inconclusive CT scan, the percentage of positive CUS was higher in older patients. In conclusion, management of elderly suspected PE patients appears to be different from both the work-up and the outcome perspectives.