Browse Internal Medicine Articles by Topic

Angiotensin II Raises Blood Pressure in Patients with Vasodilatory Shock

Infusion of recombinant angiotensin II improved blood pressure control in patients with vasodilatory shock already receiving conventional vasopressors.

Spontaneous Breathing Trials and Occam’s Razor

Different ventilator modes used for a spontaneous breathing trial affected a patient’s work of breathing (WOB) variously and differed regarding WOB measured after extubation. The clinical relevance of these differences is uncertain.

Intensive Care Enteral Nutrition in 2017

Enteral nutrition, defined as any method of feeding that uses the gastrointestinal (GI) tract (including oral feeding), usually refers to the delivery of nourishment to the GI tract through a tube. Nutrition is of utmost importance for patients suffering from a critical illness, and EN is a mainstay of nutrition in the ICU. Malnutrition and nutritional risk are common in patients admitted to the ICU. The presence of critical illness causes the body to enter a catabolic state, putting patients at risk of development or worsening of malnutrition. The Society of Critical Care Medicine and the American Society for Parenteral and Enteral Nutrition have published and revised joint guidelines to offer evidence-based recommendations for how best to feed critically ill patients.

Functional Outcomes After Receiving Life-sustaining Therapy in the ICU

Among patients who have spent at least three days in an ICU and required even brief mechanical ventilation and/or vasopressor support, almost half are dead and only one-third return to their baseline at six months. Several factors present on the first day of admission are associated with not returning to baseline status.

Frailty as a Patient Assessment Tool Prior to Aortic Valve Replacement

Assessment of frailty adds important prognostic information about risk of death and disability following both surgical aortic valve replacement and transcatheter aortic valve replacement. Among the available instruments for assessing frailty, a scale known as the Essential Frailty Toolkit demonstrated the best correlation with outcomes.

Percutaneous Coronary Interventions in Nonagenarians

Nonagenarians can undergo percutaneous coronary interventions with low in-lab complication rates, but 30-day and one-year mortality is considerably higher than in younger patients.

Palliative Care-based Intervention Improves Quality of Life in Chronic Heart Failure

Among patients with advanced heart failure, implementation of an interdisciplinary palliative care intervention was associated with improved quality of life.

Advance Care Planning Must Advance Forward

In a systematic review of 795,909 people in 150 studies, researchers found many Americans have not completed an advance directive.

Clinical Briefs

In this section: diagnosing pulmonary embolism; tackling early prostate cancer; and treating urinary tract symptoms.

Glecaprevir and Pibrentasvir Tablets (Mavyret)

The FDA has approved a dual fixed-dose combination of glecaprevir, a NS3/4A protease inhibitor, and pibrentasvir, a NS5A inhibitor, for the treatment of all major genotypes (1-6) of chronic hepatitis C infections.