Latest Articles
- Decongesting heart failure with diuretics: Easier to prescribe than to fully understand
Digging deep into the pathophysiology of diuretic resistance reveals complex interacting pathways. But none of these pathways can fully explain or be used to safely reverse diuretic resistance.
- How do I interpret and use quantitative buprenorphine and norbuprenorphine urine levels?
Confirmatory testing of urine samples can be useful in outpatient settings where buprenorphine dosing is not directly observed. But retaining and engaging the patient in effective treatment should be the ultimate goals of testing.
- How do we maximize diuresis in acute decompensated heart failure?
The initial goal is to maximize loop diuretic therapy using urine output or urinary sodium for guidance. Combination therapy can be used when patients respond poorly to escalating loop diuretic doses.
- Blue sclera: An overlooked finding of iron deficiency
The pathogenesis is thought to involve thinning of collagen fibers of the sclera due to iron deficiency, allowing the bluish color of the underlying uvea to become visible.
- Diagnostic stewardship for urinary tract infection: A snapshot of the expert guidance
New guidance on ordering, processing, and reporting urine cultures focuses on reducing unnecessary antibiotic use and the misdiagnosis of urinary tract infection.
- Hyperpigmentation as a clue to Addison disease
The 66-year-old woman presented with fatigue, loss of appetite, and hyperpigmentation of the tongue, soft palate, buccal mucosa, lower lip, fingers, and nail beds.
- Phenytoin-induced gingival overgrowth
A young man presented with lower-extremity weakness and slurred speech. He has been on seizure prophylaxis after experiencing a seizure following hemicraniectomy for subdural hematoma.
- Primary and secondary prevention of atherosclerotic cardiovascular disease: A case-based approach
The authors present commonly encountered clinical scenarios that pose challenges in decision-making in primary and secondary prevention.
- Steroids in the acutely ill: Evolving recommendations and practice
New information has been generated with regard to what causes critical illness-related corticosteroid insufficiency, how to diagnose it, who should receive corticosteroid treatment, and what regimens to use.
- Mucinous ascites: Pseudomyxoma peritonei
A 59-year-old man presented with progressive abdominal distention that limited daily activities and oral intake. The ascitic fluid was markedly viscous and jelly-like.