Erythromycin is a macrolide antibiotic that inhibits bacterial protein synthesis and is effective against the same organisms as penicillin G. The drug is commonly used to treat community-acquired pulmonary infections in penicillin-allergic patients. Erythromycin also has prokinetic effects on the gastrointestinal system. At low doses, erythromycin prokinetic agent induces activity in the gastric antrum, which […]
Gastrointestinal , gi prophylaxis guidelines in the intensive care unit (ICU) is important in the prevention of stress gastritis. The incidence of clinically significant bleeding in critically ill patients is 2% to 15%. However, it is important to understand the actual indications for prophylaxis. Most experienced clinicians feel it should be limited to patients at
In general, patients initiated on ACE inhibitors in myocardial infarction (MI) have demonstrated a reduction in overall mortality by about 20% to 30%. This benefit is most profound in patients with symptomatic congestive heart failure and their therapy should be continued indefinitely. The renin-angiotensin-aldosterone system (RAAS) regulates aldosterone release in the body via the action
Hyperglycemia, defined as blood glucose levels >110 mg/dL, has been shown in multiple studies to adversely impact outcomes in critically ill patients. Patients who are diabetic are at an increased risk for developing hyperglycemia postoperatively. With the harm of hyperglycemia in ICU now known, it is important to search out patient factors that can contribute
Trauma patients are at high risk of deep venous thromboembolism, with the majority of patients exhibiting no symptoms. Although meta-analyses report the overall incidence of deep vein thrombosis, DVT in trauma patients to be approximately 12%, the incidence of DVT in patients receiving no prophylaxis has been reported to be as high as 58%. Although
The power of a study, usually presented as a percentage, is a measure of the probability that the null hypothesis is rejected when it is false. When interpreting study results it is important to understand what is referred to as power as well as types of errors that may be encountered. Power of a study
I was asked this question on Ask a Doctor that How Clinicians Judge a Test. Sensitivity and specificity are characteristics of diagnostic tests. They inform the provider how the test will behave among people with or without disease. The sensitivity of a test is a measure of how often the test will be positive when testing
Shaping a differential diagnosis is a process of categorizing the probabilities of various diseases associated with the patient history and exam. The probability that a patient has the disease before any diagnostic testing is done is known as the prior probability of disease. Diagnostic testing increases or decreases the likelihood that a person has the
To make informed, evidence-based decisions, providers need to have an understanding of several statistical concepts. The clinical decision making process begins by assessing information by means of a history and physical examination framed within an understanding of the relative probabilities of disease states. The next step is to determine the likelihood that the patient has
Measures of association are means of estimating the strength of the relationship between observed outcomes and factors that may produce the outcome. Common measures of association are the odds ratio, relative risk, absolute risk reduction, and number needed to treat. Odds ratios are used in studies in which the incidence (or true risk) of disease
Absolute risk reduction and How Clinicians know Whether their Treatments Will Work Read More »
