Posts Tagged ‘medicine’

Ezetimibe and Cardiovascular Outcomes

Posted by • June 3rd, 2015

As you walk into Mr. R’s room to see if he has last-minute questions about his discharge medications, you can’t believe how different – how much better – he looks dressed in his usual clothes, instead of an errantly-snapped hospital gown.   You met him 4 days ago, when he was wheeled, pale and groggy, onto… Read More…

High-Flow Oxygen Therapy: a Lifesaver for Patients with Acute Hypoxemic Respiratory Failure

Posted by • June 2nd, 2015

For hospitalists and residents across the country, this is an all too familiar scenario: a 60-year-old man is admitted to the hospital with pneumonia. Unfortunately, his course is complicated by acute hypoxemic respiratory failure secondary to the pneumonia, and he is transferred to the ICU. Physicians would like to avoid intubation if possible due to… Read More…

Latent Tuberculosis Infection

Posted by • May 29th, 2015

About one third of the world population has latent M. tuberculosis infection. A new review explains the approach to patients with latent infection, including an update on the risks and benefits of treatment and assessment of the likelihood of progression to active disease. Studies suggest that active tuberculosis will develop in 5 to 15% of persons… Read More…

Intractable Pain Due to Cancer

Posted by • May 29th, 2015

In the latest Case Record of the Massachusetts General Hospital, a 44-year-old woman with metastatic non–small-cell lung carcinoma with an EGFR mutation presented with severe pain, which was worsened by opioids other than hydrocodone and was unresponsive to most other analgesics. Management decisions were made. The discomfort of most dying patients can be controlled with state-of-the-art… Read More…

Pelvic Inflammatory Disease

Posted by • May 22nd, 2015

Pelvic inflammatory disease can produce acute symptoms and result in infertility, ectopic pregnancy, and chronic pelvic pain. A new review summarizes current approaches to diagnosis and treatment and the future prospects for better prevention strategies. Pelvic inflammatory disease is an infection-induced inflammation of the female upper reproductive tract (the endometrium, fallopian tubes, ovaries, or pelvic peritoneum)…. Read More…

A Girl with Seizures

Posted by • May 22nd, 2015

In the latest Case Record of the Massachusetts General Hospital, a 9-year-old girl presented to the emergency department with loss of consciousness and a seizure. She had returned from a trip to Puerto Rico 3 weeks earlier. Unilateral inguinal lymphadenopathy was present, and rapidly progressive encephalopathy developed. The diagnosis of cat scratch disease is based primarily… Read More…

Antimicrobial Therapy for Intraabdominal Infection

Posted by • May 20th, 2015

When the paramedics wheeled Mr. L into the Emergency Department, you knew exactly what to do.  Low blood pressure: establish good IV access and start fluids. Fever of 102 and left lower quadrant abdominal pain: obtain blood cultures, order antibiotics, and get him to the CT scanner once his vitals stabilize. In medical school, you think… Read More…

Refractory Metastatic Colon Cancer

Posted by • May 15th, 2015

TAS-102, a combination of trifluridine and tipiracil in which tipiracil interferes with the deactivation of trifluridine, improved overall and progression-free survival in patients whose disease had progressed after treatment with fluorouracil-containing drug combinations. A new Original Article assesses the efficacy and safety of TAS-102 in a global population of such patients. Early clinical trials conducted primarily… Read More…

Iron-Deficiency Anemia

Posted by • May 8th, 2015

Iron-deficiency anemia is the most common form of anemia in the world. A new review article covers the global nature of the disease, iron homeostasis in normal and iron-deficient states, clinical findings, treatment, and causes of iron-resistant iron deficiency. Iron is crucial to biologic functions, including respiration, energy production, DNA synthesis, and cell proliferation. Although the… Read More…

Sick as a Dog

Posted by • May 8th, 2015

In the latest Clinical Problem-Solving article, a 42-year-old man presented to an emergency department in rural Colorado with a 2-day history of fever, cough with scant hemoptysis, chest pain, and myalgias. He reported no sick contacts and no oropharyngeal or gastrointestinal symptoms, rashes, or lymphadenopathy. Yersinia pestis is a gram-negative, facultatively anaerobic bacillus or coccobacillus and… Read More…