Browse Primary Care/Hospitalist Articles by Topic

Supreme Court cases loom large in 2016

The most consequential reproductive health-related drama in Congress in 2016 most likely played out in January.

Elevated testosterone levels might increase risk of uterine fibroids

Women who have high levels of both testosterone and estrogen in midlife might face a greater risk of developing benign uterine fibroids than women with low levels of the hormones, results of a new study indicate.¹

Antifungal drug tied to miscarriage risk

In a retrospective analysis of 1.4 million pregnancies in Denmark, use of the oral antifungal medication fluconazole during pregnancy was tied to a significantly increased risk of spontaneous abortion associated with fluconazole exposure (HR, 1.48; 95%CI, 1.23-1.77), compared with risk among unexposed women and women who used a topical antifungal during pregnancy. Until more data on the association are available, cautious prescribing of fluconazole in pregnancy might be advisable. Although the risk of stillbirth wasn’t significantly increased, this outcome should be investigated further.¹

Could premenstrual syndrome be a flag for future risk of hypertension?

Results of a new study indicate that women with moderate-to-severe PMS had a 40% higher risk of developing high blood pressure during the following 20 years compared to women experiencing few menstrual symptoms.¹

Push is on to increase postpartum use of LARC

Your next patient is a young mother of two, and her youngest child is less than a year old. While she was using combined oral contraceptives to prevent pregnancy, her busy schedule compromised compliance. The lab results are in: The pregnancy test is positive.

Delay in Performing Endovascular Reperfusion Results in Worse Disability Outcomes

In the past year, multiple clinical trials have reported that intra-arterial endovascular reperfusion with mechanical clot extraction, using the SOLITAIRE stent retriever device and others, results in better neurological outcomes than treating patients with intravenous thrombolysis alone with TPA. There is still uncertainty regarding the maximum time window, and how important early intervention is as related to neurological recovery and long-term outcomes.

Spironolactone for Resistant Hypertension

Resistant hypertension is common, and the choice of additional drug therapy in this condition is not clear.

Clinicians Are Skeptical of Early Warning Systems for Sepsis

Severe sepsis is very common, with high morbidity and mortality. Early recognition and intervention improves mortality. However, the diagnosis may often be missed in early sepsis. An academic health system developed an electronic early warning and response system for sepsis in 2012, monitoring real time vital signs and laboratory data for hospitalized, non-ICU, acute care patients and notifying clinicians when specific criteria were met.

Bedside Ultrasound: Is It a Reliable Tool for Guiding Resuscitation in Patients with Undifferentiated Hypotension?

The use of bedside ultrasound has expanded tremendously over the last few decades. As it is readily available and relatively inexpensive, ultrasound provides the opportunity to examine hypotensive, critically ill patients, potentially leading to a faster, more accurate diagnosis.

Sepsis Resuscitation and Mortality

The use of balanced salt solutions rather than isotonic saline or colloids may improve in-hospital mortality in patients admitted with septic shock.