Tag Archives: Hospital medicine

EUH Resident Report: The China Antihypertensive Trial in Acute Ischemic Stroke (CATIS) Study

The Bottom Line: The effect of antihypertensive treatment in patients with acute ischemic stroke is uncertain. This RCT concluded that bloodpressure reduction with antihypertensive medications, compared with the absence of hypertensive medication, did not reduce the likelihood of death and … Continue reading

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EUH Resident Report: A review of pustular psoriasis

The Bottom Line: Several clinical variants of pustular psoriasis exist: generalized pustular psoriasis (von Zumbusch type), annular pustular psoriasis, impetigo herpetiformis, and two variants of localized pustular psoriasis—(1) pustulosis palmaris et plantaris and (2) acrodermatitis continua of Hallopeau. Treatment of patients … Continue reading

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EUH Resident Report: Sensitivity and specificity of the Nikolsky sign

The Bottom Line: The Nikolsky sign is a moderately sensitive but highly specific tool for the diagnosis of pemphigus. Reference: Uzun, Soner, and Murat Durdu. “The Specificity and Sensitivity of Nikolskiy Sign in the Diagnosis of Pemphigus.” Journal of the … Continue reading

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Outcomes for near syncope/presyncope and syncope

Bottom line: Patients who present to the emergency department with near syncope and syncope are likely to have similar prevalence, etiology, prognosis, critical interventions, and adverse outcomes. Patients with near syncope are less likely to be admitted. Sources Grossman, Shamai … Continue reading

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Polypharmacy – number of medication-related issues in relation to number of medications

Bottom line: In cases of polypharmacy, the number of medication-related issues increases with the number of medications. Sources Steinman, Michael A, et al. “Polypharmacy and prescribing quality in older people.” Journal of the American Geriatrics Society 54.10 (2006):1516-23. “This is … Continue reading

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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

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How can the Simplified Pulmonary Embolism Severity Index (sPESI) be used to manage patients presenting with a pulmonary embolism?

The Bottom Line:  The Pulmonary Embolism Severity Index is a validated tool for predicting 30-day mortality in patients presenting at the hospital with PE.  The Simplified PESI (sPESI) predicts 30-day mortality with accuracy similar to the PESI And can assist … Continue reading

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