Hospital Medicine

  • 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.

  • How do we maximize diuresis in acute decompensated heart failure?
    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.

  • A clinical trial and another clinical practice bites the dust, or should there not be an appendix?
    Brian F. Mandell, MD, PhD
    Cleveland Clinic Journal of Medicine June 2022, 89 (6) 288-289; DOI: https://doi.org/10.3949/ccjm.89b.06022

    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?
    Anthony DeRoss, MD, FACS, FAAP and Alisan Fathalizadeh, MD
    Cleveland Clinic Journal of Medicine June 2022, 89 (6) 309-313; DOI: https://doi.org/10.3949/ccjm.89a.21012

    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
    Kamal A. Shair, MD, MEng and Razvan M. Chirila, MD
    Cleveland Clinic Journal of Medicine June 2022, 89 (6) 321-326; DOI: https://doi.org/10.3949/ccjm.89a.20137

    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 fibrillation
    Anticoagulation management of post-cardiac surgery new-onset atrial fibrillation
    Ghaith Alhatemi, MD, Mohamed Zghouzi, MD, Yasar Sattar, MD, Bachar Ahmad, BSc, Waqas Ullah, MD and M. Chadi Alraies, MD, MPH
    Cleveland Clinic Journal of Medicine June 2022, 89 (6) 329-335; DOI: https://doi.org/10.3949/ccjm.89a.21003

    A review of studies and recommendations for this condition.

  • Hampton hump in acute pulmonary embolism
    Sovik De Sirkar, MD, Joshua Newman, MD, Sorcha Allen, MB, BCh, BAO, Ahmed Elkaryoni, MD, Alexandru Marginean, MD and Amir Darki, MD, MSc
    Cleveland Clinic Journal of Medicine May 2022, 89 (5) 236-238; DOI: https://doi.org/10.3949/ccjm.89a.21058

    A 50-year-old patient presented with worsening dyspnea and cough with bilateral swelling of the lower extremities, with left-side swelling greater than right-side swelling.

  • Treating anemia: It’s not just the EPO
    Brian F. Mandell, MD, PhD
    Cleveland Clinic Journal of Medicine April 2022, 89 (4) 174-175; DOI: https://doi.org/10.3949/ccjm.89b.04022

    Long-term effects of treatment with the new oral inhibitors of prolyl hydroxylase will need to be carefully monitored, as prolyl hydroxylase is a key structural component of diverse proteins.

  • The devil is in the details: Approach to refractory hypokalemia
    Carmen Elena Cervantes, MD, Karthik Meiyappan Udayappan, MD and Duvuru Geetha, MBBS, MD
    Cleveland Clinic Journal of Medicine April 2022, 89 (4) 182-188; DOI: https://doi.org/10.3949/ccjm.89a.21013

    The authors illustrate a stepwise approach to the evaluation of acid-base disturbances.

  • Glycemic targets in the ICU: A look back, and ahead
    Keren Zhou, MD
    Cleveland Clinic Journal of Medicine April 2022, 89 (4) 189-190; DOI: https://doi.org/10.3949/ccjm.89a.21127

    Much work is still needed to understand the nuances of glycemic targets in critically ill patients, and to learn how to take advantage of evolving technology to improve glycemic control.

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