Hospital Medicine
- 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.
- Corticosteroids: Giving and taking away
Two articles this month highlight opposite ends of the treatment spectrum, one on introducing adjunctive corticosteroids when treating Pneumocystis pneumonia, and the other on syndromes associated with glucocorticoid withdrawal.
- When should I give corticosteroids to my patient with Pneumocystis pneumonia?
Patients with HIV infection who are hypoxemic should receive corticosteroids. Evidence for patients without HIV infection is limited.
- Severe hyponatremia: Are you monitoring the urine output?
A 52-year-old woman presented with confusion and a 1-month history of drastically increased alcohol intake and mild nausea and anorexia, resulting in a 15-lb weight loss.
- Management of lower-extremity venous thromboembolism: An updated review
A review of the 2021 updated guidelines of the American College of Chest Physicians including risk factors, supportive management, choice of anticoagulation therapy, and treatment considerations.
- Management of venous thromboembolism in patients with active cancer
The authors review the presentation and diagnosis of venous thromboembolism in patients with cancer and present an approach to treatment that aims to balance the bleeding risk from anticoagulation with the risk of recurrent thrombosis.
- What are the management considerations for venous thromboembolic events in patients with cirrhosis?
The authors review the current evidence on venous thromboembolic event (VTE) risk prediction in patients with cirrhosis, as well as VTE prophylaxis and anticoagulant therapy.
- Anchors away
Before you read this, I recommend that you read the interesting article in this issue by Prakash et al, part of our Symptoms to Diagnosis series.
- Elevated aminotransferases in a 62-year-old woman
Her medical history included gastroesophageal reflux disease and Sjögren syndrome. She had recently returned from travel to Malaysia.