Browse Internal Medicine Articles by Topic

TAVR in Lower-risk Patients: How Low Should We Go?

A meta-analysis of studies comparing transcatheter aortic valve replacement (TAVR) to surgical aortic valve replacement over a two-year follow-up in low surgical risk patients exhibits a higher mortality in the TAVR group, prompting the authors to recommend caution in applying TAVR to low-risk patients until randomized trials are completed.

Clinical Briefs

In this section: improving cardiovascular outcomes in type 2 diabetes patients; digging deeper into penicillin allergies; and treating osteoporosis.

Apalutamide Tablets (Erleada)

Apalutamide is indicated for the treatment of patients with non-metastatic, castration-resistant prostate cancer.

Providers Facilitate Transmission of Resistant Organisms

A closer look at the role providers play in the transmission of carbapenem-resistant Enterobacteriaceae.

Physician Burnout: A Multi-specialty Perspective

Although different specialties address the problem of physician burnout, studies suggest the most effect is gained from organizational interventions.

Another Reason to Get the Flu Shot Every Year

In a case-control study, among older adults, repeated vaccination for influenza was twice as effective in preventing severe influenza compared to non-severe influenza in patients who were admitted to the hospital.

ECMO vs. Prone Position in ARDS: The Curious Rejection of Evidence-based Practice

Despite credible evidence from a large, randomized, controlled trial and numerous meta-analyses demonstrating improved outcomes, prone position is seldom attempted prior to initiating extracorporeal membrane oxygenation to treat severe acute respiratory distress syndrome.

Critical Illness-related Corticosteroid Insufficiency: What’s New?

For critically ill patients with sepsis, septic shock, acute respiratory distress syndrome, and major trauma, a multispecialty task force of 16 international experts developed evidence-based recommendations for the diagnosis of corticosteroid insufficiency and use of corticosteroids in the ICU.

A Perspective on PEEP at 50 Years

Fifty years ago, positive end-expiratory pressure (PEEP) was introduced as an effective technique for improving oxygenation in patients with large intrapulmonary shunt, the hallmark of acute respiratory distress syndrome (ARDS). Although PEEP remains the primary means for stabilizing oxygenation in ARDS, consensus on how to approach setting it remains elusive. This is a narrative review on how our understanding and approach to PEEP has evolved over the past half century.

What Can Be Said With LBBB?

The ECG in the figure was obtained from a patient with new-onset chest pain. It was interpreted as showing complete left bundle branch block (LBBB). Thus, the provider reasoned that “it is impossible to tell if anything acute is going on because there is LBBB.” Do you agree with that assessment?