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Pulmonary Medicine

Malignant Pleural Effusion

What every physician needs to know: Malignant pleural effusion (MPE) is a common clinical problem that results in disabling breathlessness for patients with advanced malignancy. It represents disseminated disease and confers a poor prognosis. Patients often require multiple invasive procedures in order to gain a diagnosis and manage their symptomatic pleural effusions, which impacts their…
Hospital Medicine

Nephrolithiasis

Nephrolithiasis I. What every physician needs to know Stones composed of calcium phosphate or calcium oxalate make up 85-90% of renal stones in the United States. Precipitation of calcium in urine causes these stones, and stones have been linked to hypercalciuria, high salt diets, obesity, hypertension, diabetes, genetic factors, and environmental factors. Uric acid, cystine,…
Gastroenterology Hepatology

Pancreatic adenocarcinoma

How can I be sure that the patient has pancreatic adenocarcinoma? Common signs and symptoms of pancreatic cancer include fatigue, abdominal pain often radiating to the back, jaundice, nausea with or without vomiting, anorexia, early satiety, and weight loss. Additionally, up to 80% of individuals with pancreatic cancer will be shown to have glucose intolerance…
Anesthesiology

Lumpectomy and mastectomy – Procedures

What the Anesthesiologist Should Know before the Operative Procedure Breast cancer is the second leading cause of cancer death in women, and In the United States, over a lifetime, 1 in 8 women will be diagnosed with breast cancer and 1 in 35 will die from the disease. In contrast, male breast cancer is rare,…
Anesthesiology

Tracheostomy / Standard and Bedside

What the Anesthesiologist Should Know before the Operative Procedure Tracheostomy, or direct surgical opening of the trachea, is a common procedure performed in critically ill patients. The most common indication for tracheostomy is respiratory failure with ventilator dependency and the need for prolonged mechanical ventilation. Other common indications are upper airway obstruction, protection of tracheobronchial…
Anesthesiology

Glaucoma surgery

What the Anesthesiologist Should Know before the Operative Procedure Glaucoma (Greek: “opacity of the crystalline lens”) is a condition in which there is elevated intraocular pressure (IOP) which may eventually compress blood flow to the optic nerve, leading to eventual blindness. It is the second most common cause of blindness in the United States. It…
Anesthesiology

Mitral Valve Replacement

What the Anesthesiologist Should Know before the Operative Procedure Background Mitral valvular disease can be categorized as either stenotic or incompetent, albeit a third or more of patients present with both lesions. Mitral stenosis (MS) represents a pressure overload condition; whereas, mitral insufficiency or mitral regurgitation (MR) represents a volume overload state. As such, the…
Anesthesiology

Radical Hysterectomy and Abdominal Hysterectomy – Procedures

What the Anesthesiologist Should Know before the Operative Procedure Hysterectomy is the surgical removal of the uterus. Removal of the uterus may be combined with the removal of the ovaries and/or fallopian tubes. The procedure may be done for a benign condition such as bleeding, endometriosis or leiomyosarcoma. Alternatively, this procedure may be part of…
Endocrinology Metabolism

Diabetes and GI Diseases

Are You Sure the Patient Has a Gastrointestinal Complication of Diabetes? Diabetes is associated with a range of complications involving the gastrointestinal tract, biliary tree, pancreas, and liver (see Table I). Up to 75% of patients with longstanding diabetes report chronic or intermittent GI complaints resulting from abnormal sensory or motor function of the gut.…
Cardiology

Disease Management Programs: Patient Selection and Outcomes

I. Disease Management Programs: What every physician needs to know. Optimizing outcomes for patients with heart failure Disease management (DM) programs provide a systematic approach to optimizing care and outcomes for patients with heart failure (HF), the treatment of which is often complicated by one or more coexisting conditions, polypharmacy, psychosocial factors, health literacy issues,…
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