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Inpatient Medicine

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6 papers 25 to 100 followers
By Varun Shetty A Med-Peds resident
https://www.readbyqxmd.com/read/22871240/evaluation-and-treatment-of-respiratory-alkalosis
#1
Biff F Palmer
Respiratory alkalosis is the most frequent acid-base disturbance encountered in clinical practice. This is particularly true in critically ill patients, for whom the degree of hypocapnia directly correlates with adverse outcomes. Although this acid-base disturbance often is considered benign, evidence suggests that the alkalemia of primary hypocapnia can cause clinically significant decreases in tissue oxygen delivery. Mild respiratory alkalosis often serves as a marker of an underlying disease and may not require therapeutic intervention...
November 2012: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/22403272/differential-diagnosis-of-nongap-metabolic-acidosis-value-of-a-systematic-approach
#2
REVIEW
Jeffrey A Kraut, Nicolaos E Madias
Nongap metabolic acidosis is a common form of both acute and chronic metabolic acidosis. Because derangements in renal acid-base regulation are a common cause of nongap metabolic acidosis, studies to evaluate renal acidification often serve as the mainstay of differential diagnosis. However, in many cases, information obtained from the history and physical examination, evaluation of the electrolyte pattern (to determine if a nongap acidosis alone or a combined nongap and high anion gap metabolic acidosis is present), and examination of the serum potassium concentration (to characterize the disorder as hyperkalemic or hypokalemic in nature) is sufficient to make a presumptive diagnosis without more sophisticated studies...
April 2012: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/25616312/acute-pancreatitis
#3
REVIEW
Paul Georg Lankisch, Minoti Apte, Peter A Banks
Acute pancreatitis, an inflammatory disorder of the pancreas, is the leading cause of admission to hospital for gastrointestinal disorders in the USA and many other countries. Gallstones and alcohol misuse are long-established risk factors, but several new causes have emerged that, together with new aspects of pathophysiology, improve understanding of the disorder. As incidence (and admission rates) of acute pancreatitis increase, so does the demand for effective management. We review how to manage patients with acute pancreatitis, paying attention to diagnosis, differential diagnosis, complications, prognostic factors, treatment, and prevention of second attacks, and the possible transition from acute to chronic pancreatitis...
July 4, 2015: Lancet
https://www.readbyqxmd.com/read/15069420/primer-on-clinical-acid-base-problem-solving
#4
REVIEW
William L Whittier, Gregory W Rutecki
Acid-base problem solving has been an integral part of medical practice in recent generations. Diseases discovered in the last 30-plus years, for example, Bartter syndrome and Gitelman syndrome, D-lactic acidosis, and bulimia nervosa, can be diagnosed according to characteristic acid-base findings. Accuracy in acid-base problem solving is a direct result of a reproducible, systematic approach to arterial pH, partial pressure of carbon dioxide, bicarbonate concentration, and electrolytes. The 'Rules of Five' is one tool that enables clinicians to determine the cause of simple and complex disorders, even triple acid-base disturbances, with consistency...
March 2004: Disease-a-month: DM
https://www.readbyqxmd.com/read/22573847/procalcitonin-to-guide-initiation-and-duration-of-antibiotic-treatment-in-acute-respiratory-infections-an-individual-patient-data-meta-analysis
#5
Philipp Schuetz, Matthias Briel, Mirjam Christ-Crain, Daiana Stolz, Lila Bouadma, Michel Wolff, Charles-Edouard Luyt, Jean Chastre, Florence Tubach, Kristina B Kristoffersen, Long Wei, Olaf Burkhardt, Tobias Welte, Stefan Schroeder, Vandack Nobre, Michael Tamm, Neera Bhatnagar, Heiner C Bucher, Beat Mueller
BACKGROUND: Procalcitonin algorithms may reduce antibiotic use for acute respiratory tract infections (ARIs). We undertook an individual patient data meta-analysis to assess safety of this approach in different ARI diagnoses and different clinical settings. METHODS: We identified clinical trials in which patients with ARI were assigned to receive antibiotics based on a procalcitonin algorithm or usual care by searching the Cochrane Register, MEDLINE, and EMBASE...
September 2012: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/21632909/how-to-manage-type-2-diabetes-in-medical-and-surgical-patients-in-the-hospital
#6
REVIEW
Guilermo E Umpierez
Many patients admitted to the hospital have diabetes mellitus-diagnosed or undiagnosed-and others develop hyperglycemia from the stress of hospitalization. This paper discusses the prevalence, outcomes, and evidence for best management of hyperglycemia and diabetes in hospitalized patients outside the critical care setting.
June 2011: Cleveland Clinic Journal of Medicine
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