Antagonists of the P2Y12 ADP receptor, in addition to aspirin, are the mainstay of treatment of non-ST elevation acute coronary syndromes (NSTE-ACS). Although Clopidogrel (Plavix®) has been widely used for years, newer agents have come into use, including Ticagrelor (Brilinta®) and Prasugrel…
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…
Do patients with venous thrombosis require testing for inherited thrombophilia? Read the expert consensus in this review article. Here are some questions you should answer from this article: Why checking for inherited thrombophilia not clinically useful? What factors should determine…
Patients with progressive chronic kidney disease are typically initiated on hemodialysis at CKD Stage 5. But is there benefit to starting it earlier versus later in Stage 5. This studies compares initiation of hemodialysis at eGFR 10-15 versus 5-7. Here…
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.
Here are some questions to think about as you review this study: What adverse events were associated with the use of atorvastatin? Are these results externally valid and applicable to your patients diagnosed with ischemic stroke or TIA? How was…
Lactulose is widely used for treatment of hepatic encephalopathy because it is effective, cheap, and widely available. So is there any benefit to using Rifaximin in patients with hepatic encephalopathy? Here are some questions to answer when reviewing this article…
Low-molecular-weight heparin (LMWH) rather than warfarin is routinely recommended for patients with venous thromboembolism (VTE) and active cancer. Much of that is based on this article. Think about these as you review the article: Clinical Question: In patients with cancer…