Morbidity & Mortality: Heparin Drips
Morbidity & Mortality, Morning Report
High Value Care: Diagnostic Testing and Imaging
High Value Care
Two areas of the greatest healthcare expenditures and most rapid growth are diagnostic tests and imaging. Why do we over-order these tests? Think about your own decisions to order tests and view the presentation for more information. Objectives: List the…
High Value Care: Medications and Medication Reconciliation
High Value Care
High value care is not a distinct way of practicing medicine, but rather integrates with other aspects of contemporary practice. And thinking about medications from the perspective of high value care highlights these areas of overlap.
Hydrocortisone Therapy for Patients with Septic Shock
EBM, Landmark Research
Sepsis continues to affect 1.5 million people and lead to 250,000 deaths in the U.S., according to the CDC. The CORTICUS study reviewed here (article below) is the landmark study evaluating the potential benefit of corticosteroids in septic patients. As…
Reduced Lung-Cancer Mortality with Low-Dose CT Screening
EBM, Landmark Research
Lung cancer continues to be the leading cause of cancer death, ahead of colorectal, breast, and prostate cancers. However, screening strategies have been comparatively limited. This landmark article demonstrates the use of low-dose CT to screen for lung cancer, and…
The Difficult Patient Encounter
Profession of Medicine
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High Value Care: Introducing a Framework & Hospitalization for Syncope and Pneumonia
High Value Care
87% of unnecessary testing is done by physicians. But unnecessary services is just one component of the ballooning cost of healthcare in the US. Here, we illustrate the importance and context of healthcare costs and show how being cost-conscious can have an effect on how your care for patients who might require hospitalization for syncope and pneumonia.
Goals:
- Introduce the framework for thinking about high value care
- Work through decision trees for hospitalization for patients with syncope and pneumonia
Combination Therapy in Influenza
EBM, Journal Club
Influenza is still in season, and we are certainly seeing primary flu and secondary complications like pneumonia. So here’s an interesting question: does combination therapy with the addition of clarithromycin and naproxen in patients hospitalized for acute influenza have any benefit?
Effect of IV Albumin on Renal Impairment and Mortality in Patients with Cirrhosis and SBP
EBM, Landmark Research
As general internists, we often encounter and are expected to medically manage the acute complications of decompensated cirrhosis: Gastrointestional bleed Spontaneous bacterial peritonitis Hepatic encephalopathy Hepatorenal syndrome This article tackles an important cornerstone of treatment for SBP: the use of…
Adjunct Prednisone Therapy for Patients with Community-Acquired Pneumonia
EBM, Landmark Research
What role do corticosteroids have in acute infection, particularly in pneumonia requiring hospitalization? This study from Switzerland argues there might be some benefits. As you can imagine, there is some controversy about the use of steroids.