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Pediatrics

Hypopituitarism, congenital and acquired

OVERVIEW: What every practitioner needs to know Are you sure your patient has hypopituitarism? What are the typical findings for hypopituitarism? Hypopituitarism or pituitary hormone deficiency is a condition in which one or more of the pituitary hormones is are deficient. The pituitary, which plays an important role in regulation of growth, development, and metabolism,…
Anesthesiology

Lysis of Adhesions

What the Anesthesiologist Should Know before the Operative Procedure Intra-abdominal adhesions develop as a result of abdominal surgery (laparotomy or laparoscopic) or less commonly from inflammatory conditions. In fact, adhesions are the most common etiology for small bowel obstruction. While many patients who develop adhesions can be managed conservatively, some will require surgery for lysis…
Cardiology

When and in Whom Should Stress Myocardial Perfusion Imaging be Performed

General description of procedure, equipment, technique Stress myocardial perfusion imaging is a nuclear cardiology procedure that is widely used to assess patients with known or suspected coronary artery disease. This technique measures myocardial perfusion during stress, and often at rest, after the injection of a small amount of a radiopharmaceutical that is extracted by myocardial…
Critical Care Medicine

Acute Pancreatitis

1. Description of the problem What every clinician needs to know Majority of acute pancreatitis is mild to intermediate in severity; however, almost 20% can be severe with multi-system organ dysfunction within hours to days of presentation, with upward of 30% mortality for infected necrotizing pancreatitis. Key to management is early identification of those patients…
Obstetrics and Gynecology

Intrauterine Growth Restriction (IUGR)

Intrauterine Growth Restriction 1. What every clinician should know According to the ACOG practice bulletin, intrauterine growth restriction (IUGR) is “one of the most common and complex problems in modern obstetrics.” While there are several definitions of IUGR, the most widely accepted is an abdominal circumference (AC) or sonographic estimated fetal weight (EFW) <10% for…
Hospital Medicine

Hypoglycemia

I. Problem Definition. Hypoglycemia is a common metabolic emergency, defined as a blood glucose level below 60mg/dL (or 3.0mmol/L). Hypoglycemia can be asymptomatic, or can be associated with typical symptoms which can be categorized as either sympathetic effects, or those related to the impact on the brainstem. Symptoms related to sympathetic effects (or autonomic, as…
Features

Endoscopic surgery for fistula creation

A new, minimally invasive approach will decrease morbidity amonghemodialysis patients and help improve their quality of life.
Features

The effects of exercise on LDL

As LDL goals become more aggressive, therapeutic lifestyle changes are increasingly important in achieving recommended lipid levels.
Hospital Medicine

Abdominal pain: generalized

Abdominal pain is one of the top five causes for presentation to the emergency department and accounts for 18% of hospital admissions. It has one of the broadest differential diagnoses the hospitalist will confront, and therefore a methodological approach is paramount. In order to promptly identify the underlying etiology of the abdominal pain, the historian…
Obstetrics and Gynecology

Pregestational DM

Pregestational diabetes during pregnancy 1. What every clinician should know Diabetes mellitus (DM) is a chronic metabolic disorder characterized by either absolute or relative insulin deficiency resulting in persistent hyperglycemia. Estimates of diabetes concurrent with pregnancy vary widely (from 5-14%), depending upon the population in question. Most with diabetes during pregnancy have gestational diabetes (GDM),…
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