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 »
Hydroxyethyl starch also called HES or Hetastarch is a complex mixture of ethoxylated amylopectin of various molecular sizes; average MW 4.5 lac (range 10,000 to 1 million). The colloidal properties of 6% HES approximate those of human albumin. Plasma volume expands slightly in excess of the volume infused. This happens as extra vascular fluid is
Degraded gelatin polymer or Polygeline is a polypeptide with average MW 30,000 which exerts oncotic pressure similar to albumin and is not that antigenic. www.copy-swiss.me Hypersensitivity reactions are rare with Polygeline, but should watched for. It is a colloid, which is a type of fluid heavier than the commonly used fluids that are called crystalloids.
