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Cleveland Clinic Journal of Medicine
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Cleveland Clinic Journal of Medicine

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Hospital Medicine

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    What are my obligations to my incarcerated patient?
    Farah Acher Kaiksow, MD, MPP, Deval Patel, MD and Norman Fost, MD, MPH
    Cleveland Clinic Journal of Medicine January 2023, 90 (1) 18-21; DOI: https://doi.org/10.3949/ccjm.90a.22003

    A court order authorizes a blood transfusion, but the incarcerated patient refuses the transfusion. As the caregiver, am I obligated to follow the court order against the patient’s wishes?

  • You have access
    Which patients hospitalized with alcohol withdrawal syndrome should receive high-dose parenteral thiamine?
    Rahul B. Ganatra, MD, MPH, Anthony C. Breu, MD and Matthew V. Ronan, MD
    Cleveland Clinic Journal of Medicine January 2023, 90 (1) 22-25; DOI: https://doi.org/10.3949/ccjm.90a.22026

    The authors briefly outline risk factors for Wernicke encephalopathy and when high-dose parenteral thiamine is indicated.

  • You have access
    Test ordering: Balancing the good for the many with the good for the one
    Brian F. Mandell, MD, PhD
    Cleveland Clinic Journal of Medicine December 2022, 89 (12) 672-673; DOI: https://doi.org/10.3949/ccjm.89b.12022

    Three articles this month address how we order clinical tests, one on the question of treating the patient with asymptomatic bacteriuria, the others on the advantages and disadvantages of standing orders for “daily labs” for inpatients.

  • You have access
    Should ‘daily labs’ be a quality priority in hospital medicine?
    Caleb J. Murphy, MD, MBA and Andrew W. Schram, MD, MBA
    Cleveland Clinic Journal of Medicine December 2022, 89 (12) 685-688; DOI: https://doi.org/10.3949/ccjm.89a.22036

    Evidence shows that unnecessary daily testing is only a minor contributor to anemia and healthcare costs for most inpatients. The effect on patient experience has not been definitively established.

  • You have access
    Laboratory stewardship should be a priority in every hospital
    Anita J. Reddy, MD, MBA and Walter H. Henricks, MD
    Cleveland Clinic Journal of Medicine December 2022, 89 (12) 691-692; DOI: https://doi.org/10.3949/ccjm.89a.22068

    Considerations include indirect costs, downstream testing or other workup based on minor abnormalities uncovered during daily testing, and shortages in staff and supplies.

  • You have access
    Does my patient need to be screened or treated for a urinary tract infection?
    Ellen K. Kendall and Yael Mauer, MD, MPH
    Cleveland Clinic Journal of Medicine December 2022, 89 (12) 695-698; DOI: https://doi.org/10.3949/ccjm.89a.21121

    When patients present with symptoms that suggest but are not clearly diagnostic of urinary tract infection, urine studies should be obtained.

  • On the horizon: Extracorporeal carbon dioxide removal
    You have access
    On the horizon: Extracorporeal carbon dioxide removal
    Justin Hanks, DO, Steven Fox, MD, Omar Mehkri, MD, Laura W. Lund, PhD, Tracey Dill, RRT, Abhijit Duggal, MD, MPH, MSc and Sudhir Krishnan, MD
    Cleveland Clinic Journal of Medicine December 2022, 89 (12) 712-718; DOI: https://doi.org/10.3949/ccjm.89a.21084

    Extracorporeal carbon dioxide removal to treat hypercapnic respiratory failure has been studied in acute respiratory distress syndrome, chronic obstructive pulmonary disease, asthma, and other conditions.

  • You have access
    When should antithrombotic therapy be resumed after gastrointestinal bleeding?
    Dushyant Singh Dahiya, MD, Asim Kichloo, MD, FACP, Rawan Amir, MD and Farah Wani, MD
    Cleveland Clinic Journal of Medicine November 2022, 89 (11) 630-633; DOI: https://doi.org/10.3949/ccjm.89a.20189

    The timing should be individualized after considering factors related to the bleeding event, thromboembolic risk, and patient comorbidities.

  • You have access
    Decongesting heart failure with diuretics: Easier to prescribe than to fully understand
    Brian F. Mandell, MD, PhD
    Cleveland Clinic Journal of Medicine October 2022, 89 (10) 545-546; DOI: https://doi.org/10.3949/ccjm.89b.10022

    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.

  • You have access
    How do we maximize diuresis in acute decompensated heart failure?
    CME article
    Saeid Mirzai, DO, Christopher N. Kanaan, MD, Felix Berglund, MD, Maria Mountis, DO and Heba Wassif, MD, MPH
    Cleveland Clinic Journal of Medicine October 2022, 89 (10) 561-565; DOI: https://doi.org/10.3949/ccjm.89a.22016

    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.

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