David H. Wesorick, MD; Vineet Chopra, MD, MSc
Disclosures: Dr. Chopra reports grants from the Agency for Healthcare Research and Quality. Dr. Wesorick has disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M16-1400.
This analysis suggests that use of sacubitril–valsartan therapy in this patient population would be very cost-effective, based in large part on the increase in survival.
An editorial discusses slow adoption of this therapy, despite significant evidence of its superiority over conventional renin–angiotensin inhibitors. The editorial suggests that clinicians may not be aware of the evidence supporting use of these medications.
FMT is a valuable treatment option in management of patients with recurrent C difficile infection.
As discussed in an editorial, hospitalists should avoid overdiagnosis of CDI recurrence. It can lead to postinfectious irritable bowel syndrome (which can cause abnormal bowel movements after recovery from an infection), and results of stool tests can remain positive even after clinical cure.
This study corroborates the notion that frailty (i.e., reduced physiologic reserve) is predictive of poorer outcomes after surgical procedures. Consequently, measures of frailty might assist in decision making on surgical candidacy for some elderly patients.
However, the optimal strategy for measuring frailty remains uncertain, secondary to heterogeneity in the measurement tools in this study (which included measures of mobility, disability, and nutrition).
An editorial notes that translation of this knowledge into practice is limited because of the backdrop of complicated decisions regarding surgery in this patient population. More research will be needed to help clinicians know how to use these assessments to assist patients in making better decisions.
The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.
Wesorick DH, Chopra V. Annals for Hospitalists - 15 November 2016. Ann Intern Med. 2016;165:HO1. doi: 10.7326/AFHO201611150
Download citation file:
Published: Ann Intern Med. 2016;165(10):HO1.
Results provided by:
Copyright © 2018 American College of Physicians. All Rights Reserved.
Print ISSN: 0003-4819 | Online ISSN: 1539-3704
Conditions of Use