Internal Medicine

Choosing Wisely Canada-Top Five List in Hepatology: Official Position Statement of the Canadian Association for the Study of the Liver (CASL) and Choosing Wisely Canada (CWC) – Annals of Hepatology (free)

See complete lists of low-value practices: Choosing Wisely U.S. / Choosing Wisely UK / Choosing Wisely Australia AND Choosing Wisely Canada

1 – Don’t order serum ammonia to diagnose or manage hepatic encephalopathy (HE).

2 – Don’t routinely transfuse fresh frozen plasma, platelets or give Vitamin K to reverse abnormal tests of coagulation in patients with cirrhosis prior to abdominal paracentesis, endoscopic variceal band ligation, or any other minor invasive procedures.

3 – Don’t order HFE genotyping based on serum ferritin values alone to diagnose hereditary hemochromatosis.

4 – Don’t perform computed tomography (CT) or magnetic resonance imaging (MRI) routinely to monitor benign focal liver lesions (ex. focal nodal hyperplasia, hemangioma).

5 – Don’t repeat hepatitis C viral load testing in an individual who has established chronic infection, outside of antiviral treatment.

(Under a Creative Commons license)

 


Current Concepts in Acute Liver Failure

22 May, 2019 | 06:00h | UTC

Review: Chronic Constipation

2 May, 2019 | 04:31h | UTC

Chronic Constipation – Mayo Clinic Proceedings (free)

Related: Indian Consensus on Chronic Constipation in Adults (free guidelines and reviews on the subject)

 


Review: Acute Management of Hyperkalemia

28 Apr, 2019 | 13:33h | UTC

Review: Hepatorenal Syndrome

24 Apr, 2019 | 06:21h | UTC

Review: Clostridium Difficile Infection

21 Apr, 2019 | 21:16h | UTC

EASL Clinical Practice Guidelines: Drug-induced liver injury – Journal of Hepatology (free)

Related Review: Drug-induced liver injury: recent advances in diagnosis and risk assessment – Gut (free)

 

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Review article: treatment options for functional dyspepsia – Alimentary Pharmacology and Therapeutics (free)

“None of the available therapies is effective in the majority of patients without being associated with major side effects.”

 


Thyrotoxicosis: Diagnosis and Management

26 Mar, 2019 | 01:43h | UTC

Schedules for Self-monitoring Blood Pressure: A Systematic Review – American Journal of Hypertension (free)

Home blood pressure should be measured for 3 days, increased to 7 only when mean blood pressure is close to a diagnostic or treatment threshold.”

 


Vitamin K for reversal of excessive vitamin K antagonist anticoagulation: a systematic review and meta-analysis – Blood Advances (free)

Our findings indicate that patients on VKA therapy who have an INR between 4.5 and 10.0 without bleeding are not likely to benefit from vitamin K administration in addition to temporary VKA cessation.”

 


Guidelines for Antibiotic Prescription in Intensive Care Unit – Indian Journal of Critical Care Medicine (free PDF)

Source: Critical Care Reviews Newsletter

Comprehensive guideline covering many common conditions in the Critical Care Unit.

 


Signs and Symptoms That Rule out Community-Acquired Pneumonia in Outpatient Adults: A Systematic Review and Meta-Analysis – Journal of the American Board of Family Medicine (free)

Adults with an acute respiratory infection who have normal vital signs (temperature < 37,8 / respiratory rate < 20 / heart rate < 100) and a normal pulmonary examination are very unlikely to have CAP.

 


Special Issue: Hyperkalemia

6 Mar, 2019 | 20:02h | UTC

Urine Sediment Examination in the Diagnosis and Management of Kidney Disease: Core Curriculum 2019 – American Journal of Kidney Diseases (free for a limited period)

 

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Incidence of sight‐threatening diabetic retinopathy in people with Type 2 diabetes mellitus and numbers needed to screen: a systematic review – Diabetic Medicine (free PDF)

Commentary: How often should patients with T2D be screened for retinopathy? – Univadis (free registration required)

Related: Evidence‐based Guidelines for Screening of Diabetic Retinopathy (free)

“This review supports lengthening of the screening interval of patients with Type 2 diabetes without retinopathy at last screening session”

 


2019 ACIP Adult Immunization Schedule

5 Feb, 2019 | 00:39h | UTC

International Consensus Guidelines for the Optimal Use of the Polymyxins – Pharmacotherapy (free)

Endorsed by the American College of Clinical Pharmacy (ACCP), European Society of Clinical Microbiology and Infectious Diseases (ESCMID), Infectious Diseases Society of America (IDSA), International Society for Anti‐infective Pharmacology (ISAP), Society of Critical Care Medicine (SCCM), and Society of Infectious Diseases Pharmacists (SIDP).

 


Worldwide Dyslipidemia Guidelines

4 Feb, 2019 | 22:32h | UTC

American Geriatrics Society 2019 Updated AGS Beers Criteria® for Potentially Inappropriate Medication Use in Older Adults (free)

News Release: For older people, medications are common; AGS Beers Criteria aims to make them appropriate, too (free)

Commentary: AGS: Beers Criteria for Potentially Inappropriate Med Use in Older Adults Updated – MPR (free)

 

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Evidence‐based Danish guidelines for screening of diabetic retinopathy – Acta Ophthalmologica (free)

“There is solid evidence to support a flexible, individualized screening regimen. In particular, it is possible to prolong screening intervals to 24–48 months for patients with no or mild nonproliferative diabetic retinopathy”.

 


Clinical Practice Guidelines by the Infectious Diseases Society of America: 2018 Update on Diagnosis, Treatment, Chemoprophylaxis, and Institutional Outbreak Management of Seasonal Influenza – Clinical Infectious Diseases (free)

News Release: Flu is Serious for Pregnant Women and Others at High Risk: Testing and Treatment are Key, Say IDSA Guidelines (free)

 

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Dual antiplatelet therapy with aspirin and clopidogrel for acute high risk transient ischaemic attack and minor ischaemic stroke – The BMJ (free)

Commentary: Guidelines Recommend Dual Antiplatelet Therapy Immediately After TIA or Minor Stroke NEJM Journal Watch (free)

 

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ADA 2019 Standards of Medical Care in Diabetes (free supplement)

News Release: Patient-centered Care is the Focus and Priority of the 2019 Standards of Medical Care in Diabetes, Published Today by the American Diabetes Association (free)

Summary of Revisions: Standards of Medical Care in Diabetes—2019 (free)

See also: Standards of Medical Care in Diabetes—2019 Abridged for Primary Care Providers (free PDF)

 

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