More articles from 1-Minute Consult

  • When should we consider SGLT-2 inhibitors in patients with acute decompensated heart failure?
    Osamah Z. Badwan, MD, Lorenzo Braghieri, MD, Warren Skoza, MD, Ankit Agrawal, MD, Venu Menon, MD and W. H. Wilson Tang, MD
    Cleveland Clinic Journal of Medicine January 2024, 91 (1) 47-51; DOI: https://doi.org/10.3949/ccjm.91a.23034

    Evidence from clinical trials supports starting these medications as early as possible in patients hospitalized with acute decompensated heart failure who do not have clear contraindications to them.

  • Should my patients take their blood pressure medications in the evening to enhance cardiovascular benefit?
    Elias Bassil, MD, George Thomas, MD, Jagmeet Dhingra, MD and Ali Mehdi, MD, MEd, FACP, FASN
    Cleveland Clinic Journal of Medicine December 2023, 90 (12) 725-727; DOI: https://doi.org/10.3949/ccjm.90a.23043

    The focus should be to achieve blood pressure control and facilitate adherence, regardless of the timing of the medications.

  • What is the role for terlipressin in hepatorenal syndrome?
    Stephanie N. Bass, PharmD, Aanchal Kapoor, MD and Christina C. Lindenmeyer, MD
    Cleveland Clinic Journal of Medicine November 2023, 90 (11) 664-667; DOI: https://doi.org/10.3949/ccjm.90a.23037

    The drug is recommended as a first-line treatment of hepatorenal syndrome-related acute kidney injury, but it is associated with respiratory failure, especially in the setting of albumin administration, and certain comorbidities may increase the risk.

  • Is the MTHFR gene mutation associated with thrombosis?
    Andrew Dhawan, MD, DPhil and Charis Eng, MD, PhD
    Cleveland Clinic Journal of Medicine November 2023, 90 (11) 661-663; DOI: https://doi.org/10.3949/ccjm.90a.23044

    Clinicians should educate patients with this common polymorphism about the lack of evidence for associated thrombotic risk, and instead focus on modifiable risk factors for thrombosis.

  • Should I start an SGLT-2 inhibitor in my patient with heart failure and chronic kidney disease?
    Richard Sekerak, MD, Johanna Ben-Ami Lerner, MD, Pooja Prasad, MD and Megha Prasad, MD
    Cleveland Clinic Journal of Medicine October 2023, 90 (10) 607-609; DOI: https://doi.org/10.3949/ccjm.90a.23004

    These conditions often co-exist and can have complex interactions. The progression of kidney disease increases the risk of major adverse cardiovascular events.

  • Should midodrine be used as an intravenous vasopressor-sparing agent in septic shock?
    Simran Gupta, MD, Ayan Sen, MD and Aman Verma, DO
    Cleveland Clinic Journal of Medicine October 2023, 90 (10) 603-605; DOI: https://doi.org/10.3949/ccjm.90a.23040

    Research and robust data are still lacking regarding use of midodrine in this setting.

  • Should you use compression duplex ultrasonography to detect deep vein thrombosis to evaluate unexplained fevers?
    Daniel Rozenbaum, MD, Anirudh Yalamanchali, MD, MS and Deborah Hornacek, MD, FSVM
    Cleveland Clinic Journal of Medicine October 2023, 90 (10) 611-614; DOI: https://doi.org/10.3949/ccjm.90a.23018

    The authors provide recommendations on when to order imaging of the extremities in the evaluation of hospitalized patients with unexplained fever.

  • What is the most appropriate management of patients with acute decompensated heart failure who develop in-hospital hypotension?
    Lorenzo Braghieri, MD, Warren A. Skoza, MD, Osamah Z. Badwan, MD and Paulino Alvarez, MD
    Cleveland Clinic Journal of Medicine October 2023, 90 (10) 625-631; DOI: https://doi.org/10.3949/ccjm.90a.22095

    The authors offer a tailored approach to risk-stratification in these patients that focuses on early recognition and management of symptomatic and clinically significant hypotension.

  • Should I consider metformin therapy for weight loss in patients with obesity but without diabetes?
    Paloma Rodriguez, MD, Kevin M. Pantalone, DO, ECNU, FACE, Marcio L. Griebeler, MD and Bartolome Burguera, MD, PhD
    Cleveland Clinic Journal of Medicine September 2023, 90 (9) 545-548; DOI: https://doi.org/10.3949/ccjm.90a.22096

    The authors appraise the evidence to date for weight loss with metformin in this patient population.

  • If a patient has cirrhosis, should I correct coagulation abnormalities before a minor invasive procedure?
    Emily B. Wolf, MD, Marie Plante, MD and Razvan M. Chirila, MD
    Cleveland Clinic Journal of Medicine September 2023, 90 (9) 541-543; DOI: https://doi.org/10.3949/ccjm.90a.23005

    Hemostatic abnormalities in cirrhosis can include thrombocytopenia, prolonged prothrombin time, prolonged activated partial thromboplastin time, elevated international normalized ratio, and decreased fibrinogen.

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