The Medical clinics of North America
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Med. Clin. North Am. · Jul 2020
ReviewAdvances in the Management of Acute Decompensated Heart Failure.
Patients hospitalized for heart failure pose a considerable clinical and financial burden on the health care system. Early recognition and deep phenotyping of heart failure for reduced and preserved ejection fraction syndromes facilitate the introduction of appropriate guideline-directed therapy and decongestion strategies to help improve heart failure morbidity and mortality. Robust and safe transitions of care programs are needed to deliver adequate care and improve overall survival.
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Alcohol use is a common social and recreational activity in our society. Misuse of alcohol can lead to significant medical comorbidities that can affect essentially every organ system and lead to high health care costs and utilization. ⋯ Recognizing and treating common neurologic, gastrointestinal, and hematological manifestations of excess alcohol intake are essential for those who care for hospitalized patients. Withdrawal is among the most common and dangerous sequela associated with alcohol use disorder.
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Med. Clin. North Am. · May 2020
Review Comparative StudyRecognizing and Managing Polypharmacy in Advanced Illness.
Older adults, particularly those late in life, are at higher risk for medication misadventure, yet bear the burden of increasing polypharmacy. It is incumbent on practitioners who care for this vulnerable population to use one or more approaches to deprescribe medications that impose a greater burden than benefit, including medically futile medications. It is essential that health care providers use compassionate communication skills when explaining these interventions with patients and families, pointing out that this is a positive, patient-centric intervention.