Hospital Medicine
- Should every patient with an unprovoked venous thromboembolism have a hypercoagulable workup?
In the absence of consensus guidelines addressing this question, an individualized approach that considers personal and family history is needed.
- Stop the clot: When is laboratory evaluation for thrombophilia warranted?
Evidence does not support routine testing for an underlying hereditary thrombophilia after an arterial or venous thrombosis. Instead, the benefits of testing must be discussed with each patient.
- Mesenteric ischemia: Recognizing an uncommon disorder and distinguishing among its causes
Mesenteric ischemia is associated with high mortality and often poses a diagnostic challenge. Early recognition and diagnosis are imperative to improve outcomes.
- Abdominal pain without physical findings is not always without physical cause
Mesenteric ischemia is a serious clinical entity characterized by a disconnect between the patient’s symptoms and the physical examination.
- Foxglove, not quite gone or forgotten
Digoxin use has waned dramatically over the past decades, with good reason, but for select patients, it may be a very reasonable option.
- What fluids should I order for my patient with acute pancreatitis?
Recent data show that moderate fluid resuscitation is associated with fewer adverse events and that lactated Ringer’s may be superior to normal saline.
- Recurrent syncope in a 62-year-old man
The patient experienced 2 episodes of syncope over 4 weeks, had a history of recurrent carpal tunnel syndrome, and had ankle edema for the previous 18 months.
- Digoxin is still useful, but is still causing toxicity
The authors review the presentation of digoxin toxicity, its mechanisms and predisposing factors, and its medical management.