Wednesday, June 15, 2022

Diagnostic time out

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What is a diagnostic time out? Succinctly defined, it’s a deliberate exercise in differential diagnosis and systematic clinical reasoning in...
Saturday, June 11, 2022

A little more on metacognition

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This article from Academic Emergency Medicine, published in 2002, remains applicable today. It makes the point that heuristics in medicine ...

Indulge me in a little metacognition

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I found an interesting post about cognitive shortcuts in medicine. I have a minor objection to the title of the post which is Cognitive Erro...
Wednesday, May 04, 2022

Stepford doctors

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Ever since variation was declared to be an enemy of medicine there has been a multifaceted unrelenting effort to constrain the autonomy of c...
Monday, May 02, 2022

Are internal medicine’s core values effectively applied in today’s hospitalist practice?

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Hospital medicine has changed. The change has been brought by business and regulatory pressures rather than the core values of internal med...
Wednesday, August 11, 2021

Update on management of the acute abdomen in critically ill patients

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  From a recent review in Current Opinion in Critical Care Medicine : Purpose of review The aim of this study was t...

The fight to curb antimicrobial resistance: how are we doing?

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  From a recent NEJM review on this topic : In November 2019, the CDC released an updated version of its antibiotic-resista...
Friday, June 11, 2021

Primary aldosteronism: an update

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  Here's an update on this topic recently published in Cardiology in Review. The original Conn syndrome was described ...
Thursday, June 03, 2021

Procalcitonin guided antibiotic treatment is beneficial in a variety of infections

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From a recent report in the American Journal of Respiratory and Critical Care Medicine : Rationale: Although early antimicrobial discont...
Sunday, May 02, 2021

Is evidence based medicine the same as science based medicine?

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  In its original notion, yes.   In its widespread popular distortion, no.  Harriet Hall explains.    
Friday, April 16, 2021

Widespread misunderstanding of hypoxemia, hypoxia and pulse oximetry

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  A recent article in the American Journal of Respiratory and Critical Care Medicine about hypoxemia and covid-19 concludes wi...
Thursday, August 20, 2020

Anticoagulation for atrial fibrillation in stages 4 and 5 of CKD

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From a recently published study : Purpose The aim of this study was to investigate whether oral anticoagulants can provide effica...
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Wednesday, August 12, 2020

Elevated BP in hospitalized patients: what to do?

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From a recently published review : Elevated blood pressure is common in patients who are hospitalized. There are no guidelines and few r...

Cardiac complications of psoriasis

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Look at the epicardial fat. From a recent paper in the green journal : Psoriasis is a systemic inflammatory disorder that can target ad...

Updated atrial fib guidelines: the essentials

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  From Joseph S.Alpert .
Tuesday, August 11, 2020

A case of relapsing polychondritis

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From a case report and mini review in the American Journal of Medicine : McAdam and the Damiani/Levine diagnostic criteria. 12 RPC is di...

Thyroid acropachy: an unusual complication of Graves disease

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From a recent published case report and mini-review : The pathogenesis of acropachy is unknown, except for the anatomic location, in tha...
Monday, October 21, 2019

What are the risks for bad outcomes in patients admitted with influenza?

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From a recent study : Highlights A history of OSAS/CSAS, myocardial infarction and BMI greater...
Saturday, October 19, 2019

Extending VTE prophylaxis post hospitalization for medical patients

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This is not currently a recommended practice but it gets revisited from time to time. Here’s the latest systematic review a...