Cleveland Clinic journal of medicine
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Point-of-care ultrasonography (POCUS) has emerged as a vital tool in medicine. Initially used for procedural guidance, POCUS is now used for diagnostics and monitoring of the lung, heart, abdomen, and deep vein thrombosis. This wide applicability makes it an essential tool for hospitalists in daily clinical practice. This article provides an overview of the clinical integration of POCUS and basic image interpretation.
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Bulimia nervosa, a mental illness 4 times more common than anorexia nervosa, is characterized by binge-eating followed by compensatory purging behaviors, which include self-induced vomiting, diuretic abuse, laxative abuse, and misuse of insulin. Patients with bulimia nervosa are at risk of developing medical complications that affect all body systems, especially the renal and electrolyte systems. Behavior cessation can reverse some, but not all, medical complications.
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Review
Dual antiplatelet therapy after percutaneous coronary intervention: Personalize the duration.
The recommended duration of dual antiplatelet therapy (DAPT) after percutaneous coronary intervention with a drug-eluting stent has changed from 1 year for all to a more personalized approach based on the patient's risks of ischemia and bleeding. The trend is toward shorter treatment in view of lower rates of late and very late stent thrombosis with newer drug-eluting stents and the risk of bleeding with DAPT. But some patients at high risk of ischemic events and low risk of bleeding may benefit from longer treatment.
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Severe COVID-19 illness is associated with intense inflammation, leading to high rates of thrombotic complications that increase morbidity and mortality. Markedly elevated levels of D-dimer with normal fibrinogen levels are the hallmark laboratory findings of severe COVID-19-associated coagulopathy. Prophylaxis against venous thromboembolism is paramount for all hospitalized patients with COVID-19, with more aggressive prophylaxis and screening recommended for critically ill patients with D-dimer levels above 3.0 μg/mL. Point-of-care ultrasonography is the imaging method of choice for patients at high risk, as it entails minimal risk of exposing providers to the virus.