Category Archives: Therapy

EUH Krakow Conference: What is the diagnosis and treatment for complement-mediated thrombotic microangiopathy?

The Bottom Line: The clinical presentation of thrombotic microangtiopathy (TMA) reflects hemolysis and ischemic organ dysfunction, and depends on the underlying disease etiology. AKI is a common manifestation of TMAs although it is rarely a severe feature of TTP. The initial … Continue reading

Posted in Diagnosis, EUH, Therapy

EUH Hunt Conference: What is the treatment for insulinomas?

The Bottom Line:  Diet: small frequent meals throughout the day and in them idle of the night to prevent hypoglycemia (DynaMed Plus, 2017). Medications: Diazoxide is administered to suppress insulin release. For incurable islet cell carcinomas, steptozocin is the best … Continue reading

Posted in EUH, Prognosis, Therapy

EUH Krakow Conference: Treatment of thrombotic thrombocytopenic purpura (TTP).

The Bottom Line: Treat TTP as a medical emergency.  For full treatment details, see the TTP section in DynaMed Plus. Acquired TTP: Initiate plasma exchange Give methylprednisolone or high-dose oral prednisolone If plasma exchange is unavailable/delayed, consider large plasma infusions if … Continue reading

Posted in EUH, Therapy

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

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 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 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