Articles Tagged With:
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Diabetic Emergencies
Although diabetes affects various organ systems and complicates other disease processes, pure diabetic emergencies include diabetic ketoacidosis, hyperosmolar hyperglycemic syndrome, euglycemic diabetic ketoacidosis, and severe hypoglycemia. These emergencies often are precipitated in a patient with known diabetes but frequently can be the initial presentation in someone with undiagnosed diabetes. It is essential for ED providers to understand the pathophysiology, clinical features, workup, and management of these conditions, since they can be fatal, as they often were before the availability of insulin.
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Treated as Aberrant SVT
I was given this electrocardiogram without knowing details of the history beyond that the patient was an older man who was hemodynamically stable. He was being treated on the assumption that the rhythm was a supraventricular tachycardia with QRS widening because of aberrant conduction. Do you agree with this assumption? How certain are you of your answer
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Sunvozertinib (Zegfrovy) Tablets
The U.S. Food and Drug Administration (FDA) has granted an accelerated approval to sunvozertinib, a third-generation epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) for the treatment of non-small cell lung cancer with epidermal growth factor receptor (EGFR) exon 20 insertion mutations (EGFR exon20ins). The FDA also approved a companion diagnostic device, Oncomine Dx Express Test to help detect exon20ins mutations.
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Treatment Window for Lowering Blood Pressure in Acute ICH
Effective treatment for acute intracerebral hemorrhage (ICH) has remained elusive, with inconclusive results from surgical evacuations, as well as blood pressure management. The investigators performed a pooled analysis of four INTERACT trials that studied the effect of aggressive blood pressure lowering in patients with acute ICH. Ultra-early treatment (< 3 hours from onset) may be beneficial, but most patients are not so quickly diagnosed or treated.
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Routine Boosting Against Tetanus and Diphtheria in Adults: A Time to Reconsider
Slifka and colleagues make a strong argument against the routine booster vaccination of adults against tetanus and diphtheria as recommended by the Centers for Disease Control and Prevention.
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MIND Matters: Diet, Exercise, and Engagement in Cognitive Health
This multicenter, randomized clinical trial showed that a highly structured, multidomain lifestyle intervention modestly but significantly was associated with improved global cognitive function throughout two years in at-risk older adults, compared to a lower-intensity, self-guided program.
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Gabapentin and the Risk of Dementia in Adults with Chronic Pain
In a retrospective cohort study, gabapentin prescription in adults with chronic low back pain was associated with increased risk of dementia and cognitive impairment, particularly in non-elderly adults.
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Managing Suspected Preeclampsia Using the sFlt-1/PlGF Ratio
The sFlt-1/PlGF ratio is a clinically valuable tool for ruling out preeclampsia and improving obstetric decision-making, although its effect depends on appropriate use, clinician confidence in negative results, and adherence to validated protocols.
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Endometrial Biopsy: What Leads to an Insufficient Sample?
In this large retrospective cohort study at a single health system, the rate of insufficient endometrial biopsies among 27,456 patients was 12.1%. The largest risk factor for an insufficient sample was postmenopausal status (adjusted odds ratio, 5.27; 95% confidence interval, 4.88-5.70). Among premenopausal women, a history of cesarean delivery (9.6% vs. 7.2%; P < 0.001) and leiomyomas (10.3% vs. 7.2%; P < 0.001) was associated with insufficient samples.
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Is Routine Voiding Necessary Following Minimally Invasive Hysterectomy?
This unblinded, randomized clinical trial of patients undergoing minimally invasive benign nonurogynecologic hysterectomy with anticipated same-day discharge demonstrated that eliminating the requirement to void prior to discharge reduced time spent in the post-anesthesia care unit by 27.14 minutes (173.26 mins no void vs. 201.95 mins void; P = 0.002) without increasing the proportion of patients with postoperative urinary retention (3% void vs. 1% no void; P = 3.69).