notes from Dr RW

this blog has well past >500 articles. for more archives look at his page

• The patient with cirrhosis: poised to bleed or poised to clot?
• Special circumstances where warfarin is favored over DOACs
• ACC atrial fibrillation guidelines 2023
• Autonomic dysfunction as a cause of cardiovascular disease
• Nucleic acid testing for viral pathogens in community-acquired pneumonia
• Could aspergillus be hiding out in your critically ill patient?
• Antimicrobial resistance in critically ill patients
• ANCA testing in eosinophilic granulomatosis with polyangiitis (EGPA)
• Myths and facts in antibiotic stewardship
• Diagnostic time out
• A little more on metacognition
• Indulge me in a little metacognition
• Stepford doctors
• Are internal medicine’s core values effectively applied in today’s hospitalist practice?
• Update on management of the acute abdomen in critically ill patients
• The fight to curb antimicrobial resistance: how are we doing?
• Primary aldosteronism: an update
• Procalcitonin guided antibiotic treatment is beneficial in a variety of infections
• Is evidence based medicine the same as science based medicine?
• Widespread misunderstanding of hypoxemia, hypoxia and pulse oximetry
• Anticoagulation for atrial fibrillation in stages 4 and 5 of CKD
• Elevated BP in hospitalized patients: what to do?
• Cardiac complications of psoriasis
• Updated atrial fib guidelines: the essentials
• A case of relapsing polychondritis
• Thyroid acropachy: an unusual complication of Graves disease
• What are the risks for bad outcomes in patients admitted with influenza?
• Extending VTE prophylaxis post hospitalization for medical patients
• ICU or stepdown for your DKA patient?
• Delirium in hospitalized patients predicts readmission and other forms of increased post hospital utilization
• The cholesterol hypothesis is alive again!
• Check point inhibitor induced colitis
• Which patients post cardiac arrest need to go straight to the cath lab?
• Cardiorenal syndrome
• Rates of cardiac testing prior to hip fracture surgery
• Blood stream infections: how long to treat? When is PO sufficient?
• Non invasive ventilation for acute hypoxemic respiratory failure: what’s the latest?
• Biomarkers in midlife may predict physical decline years later
• Adverse drug reactions in the elderly: a clinical vignette and a reminder of the Beers list
• Antiplatelet therapy reduces mortality in sepsis
• Management of acute kidney injury
• A fib ablation vs antiarrhythmic medication
• Should you get immunoglobulin levels on patients admitted with community acquired pneumonia?
• Should docusate be removed from your hospital’s formulary?
• Prealbumin testing is not useful in the assessment for malnutrition
• Very low utilization of advance care planning (ACP) CPT codes among hospitalists
• Survey data on the state of research in hospital medicine
• Are residents getting enough training in managing crashing patients in the hospital?
• Atul Gawande on the electronic medical record
• The EMR mess and its horrible consequences
• Extended infusion protocols for piperacillin-tazobactam (PTZ): do they mitigate nephrotoxicity?
• A little background on thalidomide
• Syncope guidelines
• Visceral fat: an inflammatory engine driving worse outcomes in sepsis?
• Strength training improved cognition in older patients
• What explains strokes in young people (ages 18-55)?
• Do you really need a TSH receptor antibody test to distinguish Grave’s disease from other forms of hyperthyroidism?
• Low vitamin D levels associated with increased mortality
• Testosterone replacement associated with better cardiovascular outcomes
• Troponin elevation in stroke may point to a cardioembolic etiology
• Appropriateness of troponin ordering in the hospital
• Triple antibiotic therapy against carbapenemase producing bacteria
• Targeted temperature management post arrest: how long?
• Vitamin C deficiency as a cause of pulmonary hypertension
• Hospitalization rates and lengths of stay for VTE in Alberta Canada
• In non malignant pleural effusions transudates may have a worse prognosis than exudates
• Adjuvant metolazone (zaroxalin) in loop diuretic refractory patients
• Hepatic encephalopathy update
• The adverse effects of CPOE on ER throughput
• Can voice patterns give away your risk of CAD?
• Is thrombophilia testing helpful?
• Checking urine eosinophils to evaluate for acute interstitial nephritis
• Growing evidence challenges conservative transfusion dogma
• Thrombocytopenia developing in hospitalized patients
• What the hospitalist needs to know about the TTP-HUS spectrum
• Be careful using a restrictive transfusion strategy in patients with cardiovascular disease
• Visceral fat (android obesity) and oxidative stress
• Unintended consequences of patient safety interventions
• Unraveling the mystery of thrombotic storm
• Is less really more? Under treatment with antithrombotic therapy still a huge problem
• A virtual museum of mechanical ventilators
• Using ventilator graphics
• Medical decision making for unbefriended older adults: an AGS position statement
• Diagnosis of upper extremity DVT
• Systematic review and meta-analysis of tygecycline in bloodstream infections
• Topiramate renal toxicity
• Troponin elevation in stroke: what does it mean?
• Thrombolytic versus conventional therapy for submassive PE
• Syncope review
• What to do with subclinical hyperthyroidism
• Increased risk of stroke after an episode of sepsis
• Stressed volume in critical care
• Get those discharge summaries out. Faster please.
• Single dose dexamethasone almost as affective as a five day prednisone regimen in acute asthma
• The strong ion difference in predicting the severity of acute pancreatitis
• Chronic tachycardia induced cardiomyopathy
• An evidence summary on severe asymptomatic hypertension
• Testosterone and cardiovascular health
• Septic encephalopathy
• Should we reinvent the physical exam?
• A single ectopic beat on a 12 lead ECG is an important predictor
• Reducing blood culture contamination with a special collection device
• RALES disease
• P wave indices and risk of ischemic stroke
• Spontaneous pneumothorax (apparent primary spontaneous pneumothorax) may be the first clue to certain cystic lung diseases
• Pseudo subarachnoid hemorrhage in post anoxic brain injury
• Emerging long term risks of proton pump inhibitors
• Some medical axioms
• Early arterial ischemic events after VTE in cancer patients
• ARDS: are we making a dent?
• Amp-C beta lactamase producing organisms
• Review of motor neuron disease
• Autoimmune thyroid disease
• The relationship between atrial fibrillation and dementia
• Acute exacerbation of IPF
• Adrenal crisis
• Trends in the use of ACLS drugs
• Effect of angiotensin II in patients with vasodilatory (mainly septic) shock requiring renal replacement therapy
• Procalcitonin monitoring can help shorten the duration of antibiotic therapy in pneumonia
• Can procalcitonin help predict the microbiology of community acquired pneumonia?
• Renin-aldosterone profiling for all hypertensives? Have we come full circle?
• PPI use may be associated with better heart failure outcomes
• Sherlock Holmes and clinical skills
• Paget’s disease of bone
• Impella may gradually replace the balloon pump in cardiogenic shock
• More uncritical praise for the hospitalist movement
• Doctors: shut up!
• The Fourth Universal Definition of Myocardial Infarction
• Health care team members’ perceptions and attitudes about emergency only hemodialysis (EOHD)
• Annals article on EBM and machine learning makes huge category errors
• Why are patients not forthcoming? Is it because we’re addressed as “Doctor”?
• Sep 1: thumbs up or thumbs down?
• STEMI treated with PCI: very low incidence of LV thrombus compared with historical data
• Statins may reduce lung related and all cause mortality in COPD
• Livedo reticularis versus livedo racemosa
• Secondary sclerosing cholangitis in critically ill patients (SSC-CIP)
• Limitations of clinical trials with surrogate endpoints
• A prediction tool for early recognition of spinal epidural abscess
• Psychological benefits of a single exercise session
• Smart Mat technology can detect diabetic foot ulcers a month in advance
• The yield of sputum cultures in hospital acquired pneumonia
• Spontaneous bacterial peritonitis
• Severe carisoprodol withdrawal
• Losing our clinical focus: hospitalists as social workers
• Longer sleep duration is associated with lower CRP levels
• Stool PCR panels
• Spinal epidural abscess and diagnostic errors
• If the patient’s using a smart phone on rounds they may be close to discharge
• Sleep apnea update
• Fighting C diff: the case for gastric acid suppressant stewardship