Internal Medicine
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ECMO vs. Prone Position in ARDS: The Curious Rejection of Evidence-based Practice
Despite credible evidence from a large, randomized, controlled trial and numerous meta-analyses demonstrating improved outcomes, prone position is seldom attempted prior to initiating extracorporeal membrane oxygenation to treat severe acute respiratory distress syndrome.
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Critical Illness-related Corticosteroid Insufficiency: What’s New?
For critically ill patients with sepsis, septic shock, acute respiratory distress syndrome, and major trauma, a multispecialty task force of 16 international experts developed evidence-based recommendations for the diagnosis of corticosteroid insufficiency and use of corticosteroids in the ICU.
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A Perspective on PEEP at 50 Years
Fifty years ago, positive end-expiratory pressure (PEEP) was introduced as an effective technique for improving oxygenation in patients with large intrapulmonary shunt, the hallmark of acute respiratory distress syndrome (ARDS). Although PEEP remains the primary means for stabilizing oxygenation in ARDS, consensus on how to approach setting it remains elusive. This is a narrative review on how our understanding and approach to PEEP has evolved over the past half century.
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What Can Be Said With LBBB?
The ECG in the figure was obtained from a patient with new-onset chest pain. It was interpreted as showing complete left bundle branch block (LBBB). Thus, the provider reasoned that “it is impossible to tell if anything acute is going on because there is LBBB.” Do you agree with that assessment?
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Clinical Briefs
In this section: Managing postprandial glucose excursions in diabetic patients, strategies for improving long-term outcomes for obesity patients, and effectively treating Crohn's disease.
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Vancomycin HCl for Oral Solution (Firvanq)
Vancomycin oral solution is indicated for adults and pediatric patients < 18 years of age for Clostridium difficile-associated diarrhea and enterocolitis caused by Staphylococcus aureus (including methicillin-resistant strains).
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Aerobic Exercise and Cognitive Impairment
Progressive aerobic exercise training appears to be a low-risk and effective intervention for improving cognitive function in community-dwelling adults with mild subcortical ischemic vascular cognitive impairment.
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Type 2 Diabetes Is Reversible
Type 2 diabetes is reversible (or can be put in remission) in a primary care practice through an intense low-carbohydrate weight management program.
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Chiropractic Spinal Manipulation for Migraine
Chiropractic spinal manipulation offers no benefit over placebo for migraineurs.
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Noncow Milk for Young Children: An Observational Study Regarding Height
Data from more than 5,000 Canadian children reveals a dose-dependent association between drinking noncow milk and lower height in early childhood.