Category Archives: Grady

Kokko Conference: Do protease inhibitors lead to improved outcomes in AL cardiac amyloidosis?

The Bottom Line: . In a study of diflunisal in ATTR cardiac amyloidosis (both mutant and wt), stable mean left ventricular (LV) mass, LVEF and cardiac biomarkers were seen during the course of therapy.  Nephrotoxicity and volume overload was observed as … Continue reading

Posted in Grady, Therapy

Grady Report: What are the current guidelines for the pharmacological management of prostatitis?

The Bottom Line: For healthcare providers, the focus of therapy is symptomatic relief. The first therapeutic measure is often a 4- to 6-week course of a fluoroquinolone, which provides relief in 50% of men and is more efficacious if prescribed … Continue reading

Posted in Background question, Grady, Therapy

When should a head CT be performed prior to a lumbar puncture?

Lumbar puncture/Procedure considerations/Neuroimaging in Dynamed The section on Testing to Consider Prior to Performing an LP in DynaMed’s entry for lumbar puncture summarizes two prospective cohort studies and lists clinical findings such as age and aspects of clinical history and … Continue reading

Posted in Diagnosis, EUH, EUHMidtown, Grady | Tagged ,

Is there a systematic evaluative approach to adults with thrombocytopenia?

The Bottom Line: See Figure 1, p. 193, “Algorithm for workup of thrombocytopenia based on observation of the peripheral blood film.” Reference: Stasi R.  How to approach thrombocytopenia.  Hematology Am Soc Hematol Educ Program. 2012;2012:191-7.  Summary: The initial approach to determining the … Continue reading

Posted in Applying evidence, Diagnosis, Grady

What is the prophylactic agent of choice for HIV+ adults with mycobacterium avium complex?

The Bottom Line: Azithroymycin or clarithromycin appear to be the agent of choice for MAC infections.  Further studies are needed, especially direct comparison of these two therapies. Reference: Uthman MM, Uthman OA, Yahaya I.  Interventions for the prevention of mycobacterium avium … Continue reading

Posted in Grady, Therapy

What is the differential diagnosis for patients presenting with proctitis and a history of HIV infection?

Bottom line:  In patients presenting with proctitis and a history of HIV infection, a sexual history of a man who has sex with men suggests a risk for sexually-transmitted infections:   gonorrhea, herpes simplex, chlamydia, and syphilis (in descending order … Continue reading

Posted in Diagnosis, Grady | Tagged

Who is at risk for lymphogranuloma venerum (LVG) proctitis and what is a typical presentation?

The Bottom Line:  Risk factors include having large numbers of sexual partners and high rates of unprotected anal sex.  Purulent anorectal discharge, pain and bleeding typify LGV proctitis symptoms and occur in most proctitis cases. Tenesmus and constipation, while less frequent, when … Continue reading

Posted in Diagnosis, Grady | Tagged