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Hospital Medicine

Adult respiratory distress syndrome

Acute Respiratory Distress Syndrome I. What every physician needs to know. Acute Respiratory Distress Syndrome (ARDS) also known as, adult respiratory distress syndrome (previously non-cardiogenic pulmonary edema) is a syndrome of acute respiratory failure characterized by bilateral diffuse alveolar infiltrates on chest radiography and resulting hypoxemia. ARDS begins with an injury that results in an…
Pulmonary Medicine

Thoracic Surgical Procedures (include mediastinoscopy, VATS, tube thoracostomy, pleuroscopy and thoracoscopy)

General description of procedure, equipment, technique Thoracic surgery encompasses a broad spectrum of procedures. Frequently performed, less invasive procedures include mediastinoscopy, tube thoracostomy, pleuroscopy or thoracoscopy, and video-assisted thoracoscopic surgery (VATS). Mediastinoscopy Mediastinoscopy is a procedure in which a mediastinoscope is inserted into the mediastinum through a small incision. The procedure is typically used for…
Hospital Medicine

Acute pancreatitis

Acute pancreatitis is a disease characterized by acute inflammation of the pancreas, commonly as a result of excessive alcohol use or secondary to gallstones. Every year in the United States, it is responsible for over 200,000 hospital admissions leading to more than $2 billion in healthcare expenses. Patients usually present with rapidly escalating right upper…
Anesthesiology

Endocrine disorders in pregnancy (e.g., thyroid, diabetes)

What the Anesthesiologist Should Know before the Operative Procedure Endocrine disorders are important causes of perioperative morbidity and mortality. Nearly all are associated with changes in fluid and electrolyte homeostasis and hemodynamic alterations from dysfunction of the hypothalamic pituitary adrenal axis. Because nearly all tissues respond to endocrine hormones, endocrine diseases are associated with multisystem…
Anesthesiology

Thoracic Aortic Procedures – Arch or Hemiarch Procedures

What the Anesthesiologist Should Know before the Operative Procedure Open thoracic surgery for aortic repair or replacement is performed for the treatment of aortic aneurysms and dissections. A thoracic aortic aneurysm has a localized vessel diameter 50% more than the normal value (adjusted for age and height), whereas an aortic dissection is the structural violation…
Obstetrics and Gynecology

Male Infertility

Male Infertility (Azospermia, Oligospermia, Aspermia, and Varicoceles) 1. What every clinician should know Male infertility Infertility is defined as the inability for a couple to achieve a pregnancy after 1 year of regular unprotected intercourse. Having said that, the following infertile couples should undergo a medical evaluation prior to 1 year. (1) male-specific risk factors…
Pulmonary Medicine

Disorders of the Central Airways and Upper Airway Obstruction

What every physician needs to know: The upper airway is defined as the airway segment between the nose or mouth and the main carina, which is located at the lower end of the trachea. The central airways refer to the trachea and the main-stem bronchi. Unlike the lower conducting airways, such as the main, lobar,…
Anesthesiology

Interstitial laser thermal therapy for benign prostatic hyperplasia

What the Anesthesiologist Should Know before the Operative Procedure Benign prostatic hyperplasia (BPH) is a progressive condition associated with symptoms of the lower urinary tract, specifically urinary retention or obstructed urinary flow. The prevalence of BPH increases with patient age, affecting more than half of men in their sixth decade of life. Traditionally, the management…
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,…
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.…
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