Hospital Medicine
- 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.
- Should an NPO order be placed for my patient with acute pancreatitis?
Resting the pancreas with extended periods of nothing by mouth status or total parenteral nutrition is no longer considered the standard of care.
- Do I always need a central venous catheter to administer vasopressors?
Although generally preferred, central venous catheters carry risks such as procedural complications, infection, and thrombosis. Clinicians must assess, case by case, whether a peripheral intravenous catheter can be used.