Morning Report: Alcohol Withdrawal Syndrome
Thank you Dr. Christina Chung for an excellent presentation on alcohol withdrawal syndrome in a patient with altered mental status. Key Learning Points: Mild EtOH withdrawal symptoms can begin as early as six hours after last drink The classic tremor…
Morning Report: Pernicious Anemia
Thank you Dr. Kumar for an excellent case presentation on vitamin B12 deficiency secondary to pernicious anemia in a patient with Graves' disease and Vitiligo. Key Learning Points: Remember: B12 (cobalamin) levels are neither sensitive nor specific for the diagnosis…
Guide to NOACs: Trials and Tests
Thrombolysis with Alteplase 3 to 4.5 Hours after Acute Ischemic Stroke (ECASS III)
Time is tissue—and the brain is no exception. Here's the landmark article guiding our use of thombolytics within 4.5 hours of an acute stroke. Remember, the clock starts ticking from the patient's last well-known time, not from the time of…
Viral Hepatitis Screening and Vaccination
Clinical Trial of the Effects of Dietary Patterns on Blood Pressure (DASH)
Hypertension—one of the top chronic conditions we face— involves a multipronged approach to management. In addition to pharmacotherapy, never forget to start with lifestyle modifications. Here we review the Dietary Approach to Stop Hypertension, from which the combination DASH diet…
Intensive versus Conventional Glucose Control in Critically Ill Patients (NICE-SUGAR)
This classic, often-cited article informs us that among patients in the ICU, intensive glucose control of 81-108 increased mortality as compared to a more liberal glucose target of <180. How have you applied the findings of this research to your…
STOP-IT: Is a Short Course of Antibiotics Adequate for Intraabdominal Infections?
Current antibiotic stewardship guidelines at Olive View recommend 4 days of antibiotics for intraabdominal infections once source control is achieved. Here is clinical evidence of this "short" duration of antibiotics.
Symptom-triggered versus Fixed-schedule Doses of Benzodiazepine for Alcohol Withdrawal
The Ativan Protocal at Olive View is a symptom-based algorithm for treatment of alcohol withdrawal. Here's the evidence for use of the symptom-based CIWA scale to determine the dosing of lorazepam as compared to fixed dosing of benzodiazepine. Read the…