Category Archives: EUH

EUH Dressler Conference: What are standard treatments and NSAIDS for pericarditis?

The Bottom Line:  Aspirin or non-steroidal anti-inflammatory drugs are standard first-line therapy for acute pericarditis. Acute pericarditis (for complete information, see DynaMed Plus): ibuprofen 600 mg every 8 hours for 1-2 weeks, then taper by 200-440 mg every 1-2 weeks until … Continue reading

Posted in Applying evidence, EUH, Therapy

EUH Dressler Conference: What is the clinical exam for pericardial tamponade?

The Bottom Line: Among patients with cardiac tamponade, a minority will not have dyspnea, tachycardia, elevated jugular venous pressure, or cardiomegaly on chest radiograph. A pulsus paradoxus greater than 10 mm Hg among patients with a pericardial effusion helps distinguish those … Continue reading

Posted in Diagnosis, EUH

EUH Morning Report: Delayed paracentesis and mortality risk with spontaneous bacterial peritonitis

The Bottom Line: In a study of hospitalized patients with spontaneous bacterial peritonitis (SBP), Kim et al (2014) concluded: Patients who receive delayed paracentesis (DP) had a higher in-hospital mortality (27% vs 13%) compared with those who received early paracentesis (EP). … Continue reading

Posted in Diagnosis, EUH, Therapy

EUH Morning Report: Diagnosing ascites

The Bottom Line: Three guidelines are most useful when determining if a patient has ascites (Williams and Simel, 1992, p.2648): The most useful findings for ruling out ascites are negative histories of ankle swelling or increased abdominal girth, and the inability  … Continue reading

Posted in Diagnosis, EUH

EUH Morning Report: Can PE be ruled out with a D-Dimer of less than 1000?

The Bottom Line: The YEARS algorithm simultaneously assesses three items – clinical signs of DVT, hemoptysis, and whether PE is the most likely diagnosis – as well as a D-dimer test threshold of 500 ng/mL in presence, and 1000 ng/mL in … Continue reading

Posted in Diagnosis, EUH

EUH Dressler Conference: What are HIV elite controllers and HIV long-term nonprogressors?

The Bottom Line: Long-term nonprogressors (LTNP) account for 1-5% of HIV-infected individuals characterized by documented infection for more than 7-10 years, a stable CD4+ T cell count over 500/mm3 and low viremia in the absence of antiretroviral treatment. They are able … Continue reading

Posted in Background question, Diagnosis, EUH, Intern toolbox, Teaching pearls

EUH Hunt Conference: What trials have been done on early vs. later initiation of ARTs in the hospital for opportunistic infections in the setting of HIV?

The Bottom Line:  Karim et al (2010): An open-label randomized controlled trial in Durban, South Africa to determine optimal timing of ART initiation in relation to TB treatment. Acid-fast bacilli (AFB) smear positive tuberculosis patients with HIV infection and CD4+ counts … Continue reading

Posted in Background question, EUH, Therapy