Postgraduate medicine
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Postgraduate medicine · Dec 2005
ReviewDiagnosing acute otitis media: it's what you see, not what you hear.
Diagnosing acute otitis media (AOM) is quite challenging for physicians and especially other healthcare providers. Although the new guidelines from the American Academy of Pediatrics/American Academy of Family Physicians provide some guidance for making the correct diagnosis of AOM, overdiagnosis will still remain a problem. ⋯ Implementing these recommended practices can reduce the uncertainty that typically arises in diagnosing AOM. This paper also addresses questions that can arise when applying guideline criteria.
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Postgraduate medicine · Dec 2005
Case ReportsUsing beta-blockers to cut perioperative risk in CAD. Cardioprotective strategies for noncardiac surgery.
Postoperative adverse myocardial ischemic events, such as infarction, unstable angina, and cardiac death, are common in patients with coronary artery disease (CAD). These events can be prevented in many patients with strategies such as the perioperative use of beta-blockers. In this article, the authors present four cases and discuss perioperative evaluation of patients having a noncardiac operation to determine risk of an adverse cardiac event after the procedure. Evidenced-based approaches to reducing the chances of an undesirable outcome in high-risk patients, such as preoperative testing and procedures and the use of beta-blockers, are presented.
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Atrial fibrillation (AF) is a common cardiac arrhythmia, especially in elderly persons. Current recommendations outline pharmacologic and interventional therapies designed to minimize the risk of stroke and other morbidities that can accompany this condition. In this article, Drs Basu Ray and Heist review treatment options for cardioversion and control of rate and rhythm and make suggestions for best management in patients with chronic or intermittent AF.
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Postgraduate medicine · Sep 2005
ReviewBedside evaluation of cardiac markers. Point-of-care testing can differentiate acute coronary syndromes.
Accurate and rapid diagnostic tests can help identify high-risk patients with ACS among those presenting to the emergency department with chest pain. Such tests can also differentiate low-risk patients with chest pain who are suitable for early emergency department discharge. In this article, Drs Amsterdam and Deedwania elucidate the varieties of ACS, their pathophysiology, and the methods used for diagnosis. The authors also explore the potential of point-of-care testing for cardiac injury markers in the timely and accurate identification of ACS.