1. Interesting news about mechanical kidneys currently being developed in the Economist's technology quarterly-- one model, which is basically a tiny wearable dialysis machine, runs diasylate in a coutercurrent flow across a membrane from blood, and then transfers the waste to a solid sorbent, which can be disposed of. In this way requiring much less fluid than a traditional dialysis machine. Another model being developed utilizes the body's heart rate instead of an internal pump, and involves constructing a filter out of layers of silicon alternating with kidney tubular epithelial cells (harvested from kidneys unsuitable for transplant). The advantage of this system is the ability to recover glucose and electrolytes from the filtered blood. Currently, it is not yet in trials in people, and when it is probably will require immunosuppressants still. But it's easy to imagine seeding these silicon filters with harvested stem or iPS cells from the recipient. (Economist)
2. Using an inhaler without a spacer decreases the efficacy by 40-60%
3. Immediately after an albuterol nebulizer treatment, the user's sats will drop due to a V/Q mismatch. Blood had been shunted away from previously hypoxic/non-aerated parts of the lung, and albuterol affects the b-2 receptors in blood vessels before the b-2 receptors in bronchial smooth muscle-- the reperfusion of blood happens before re-aeration of the same part of the lung.
4. The NNT to prevent acute mastoiditis in uncomplicated AOM (i.e. no fevers, otorrhea) is 4800. Antibiotics do not improve pain at 24 hours; the NNT to improve pain at 2-7 days is 20. Antibiotics do prevent tympanic membrane perforations (NNTB: 33) and contralateral AOM (NNTB: 11). However, the number needed to harm for side effects of antibiotics that otherwise wouldn't have happened (diarrhea, vomiting, rash) was 14. The antibiotics were most beneficial for kids under 2 years with bilateral AOM, or with both b/l AOM and otorrhea. Other kids do not benefit. (cochrane review)
5. If you suspect CHF in a child-- look for S3, S4, hepatic enlargement, edema (can be hard to visualize-- look for recent acute weight changes). CHF due to congenital heart disease will often manifest as failure to thrive, poor weight gain, stressful feeding (sweating, panting, increased work of breathing)
6. For MRSA pneumonia: clinda has much better lung penetration than vanc. And it's delicious! Like drinking sugar water. Linezolid works but is really, really expensive.
7. Hematopoietic stem cell transplant is one of the few treatments that have shown to be of benefit in Krabbe's disease; transplants are from umbilical cord blood, either autologous or matched donors. Transplants do not cure the disease, but they do slow the progression/onset of the neurodegeneration. Of note, transplants are generally regarded as most effective before the onset of symptoms. A 2005 study in the NEJM of 22 infants, half who received transplant and half who didn't, showed that at 3-4 years postop, among those who got a transplant before the onset of symptoms, survival was 100% and nearly all had age-appropriate development of cognitive and language skills, although about half showed delays in motor skills. Among those who got a transplant after the onset of symptoms, survival and outcomes were comparable with untreated controls. (NEJM)
8. Steroids do not affect renal outcomes in patients with HSP. 
9. In the winter, bronchiolitis is usually RSV. In the summer, it's more likely to be parainfluenza, rhino/corona, adeno, or influenza.
10. Someone who is very tachypneic may not be able to take PO meds (i.e. steroids)-- they may aspirate.