Hospital Medicine
- Fungus among us: A poster child for diagnostic stewardship
When interpreting the significance of Aspergillus species in respiratory culture, first ask if the culture was clinically indicated, or if this was an incidental finding.
- Is Aspergillus isolated from respiratory cultures clinically significant?
Aspergillus is ubiquitous, so the significance of the finding depends on the patient’s symptoms, underlying lung condition, immune status, and radiologic fi ndings.
- Coronary microvascular dysfunction: Considerations for diagnosis and treatment
A review of pathophysiology, considerations for invasive and noninvasive coronary function testing, management, and remaining knowledge gaps.
- Medical, ethical, and legal aspects of end-of-life dilemmas in the intensive care unit
Three hypothetical cases elucidate medical, ethical, and legal considerations in common end-of-life situations encountered in the ICU.
- Can I place a peripherally inserted central catheter in my patient with chronic kidney disease?
Future need for permanent dialysis access is an important consideration.
- The obesity paradox in heart failure: What is the role of cardiorespiratory fitness?
What should these patients be advised about weight management and about cardiorespiratory fitness, a major factor influencing the paradox?
- ‘Guidelines to Practice’ series: Asthma in adults
A clinically useful summary, highlighting the practical and newer conceptual aspects of the guidelines.
- Aspiration of a partial denture after an ischemic stroke
A bedside evaluation inaccurately led to the conclusion that it was safe to advance to a dysphagia diet.
- Outpatient management of asthma in adults: A snapshot of the 2020 GINA report
A review of the guidelines, with a focus on what’s new and clinically important.
- What antithrombotic therapy should I use for my patient with atrial fibrillation who underwent percutaneous coronary intervention or had an acute coronary syndrome?
The risk of thrombosis should be balanced with the risk of bleeding.