Hospital Medicine
- Laboratory stewardship should be a priority in every hospital
Considerations include indirect costs, downstream testing or other workup based on minor abnormalities uncovered during daily testing, and shortages in staff and supplies.
- Does my patient need to be screened or treated for a urinary tract infection?
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 removalExtracorporeal carbon dioxide removal to treat hypercapnic respiratory failure has been studied in acute respiratory distress syndrome, chronic obstructive pulmonary disease, asthma, and other conditions.
- When should antithrombotic therapy be resumed after gastrointestinal bleeding?
The timing should be individualized after considering factors related to the bleeding event, thromboembolic risk, and patient comorbidities.
- 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 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.
- A clinical trial and another clinical practice bites the dust, or should there not be an appendix?
Studies over the past 2 decades have assessed an alternative approach to acute appendicitis: treatment with systemic antibiotics and observation.
- Appendicitis management: Is it time for a change?
Antibiotic therapy has been a successful alternative to surgery for more than 60 years, but surgery is still the primary treatment.
- Dyspnea and cough in a lung transplant recipient
The patient developed sudden shortness of breath at rest, a decline in home spirometry values, and dry cough and fatigue.
Anticoagulation management of post-cardiac surgery new-onset atrial fibrillationA review of studies and recommendations for this condition.