Episode 283: 282. New Guidelines For Management of Acute Pancreatitis

Episode 283: 282. New Guidelines For Management of Acute Pancreatitis

https://journals.lww.com/ajg/fulltext/2024/03000/american_college_of_gastroenterology_guidelines_.14.aspx


2 of the 3 following criteria: (i) abdominal pain consistent with the disease, (ii) serum amylase and/or lipase greater than 3 times the upper limit of normal, and/or (iii) characteristic findings from abdominal imaging



Fluid--

  • Moderately aggressive fluid resuscitation with lactated Ringer's solution should be started (NEJM JW Gen Med Oct 1 2023 and Am J Gastroenterol 2023; 118:2258), defined as a bolus of 10 mL/kg followed by infusion of 1.5 mL/kg/hour (NEJM JW Gen Med Oct 15 2022 and N Engl J Med 2022; 387:989), and additional boluses can be given if a patient has evidence of hypovolemia.



Feeding-- Early oral feeding (within 24–48 hours) should begin with a low-fat solid diet (as opposed to liquid) for patients with mild AP.




Surgery-

Patients with mild acute biliary pancreatitis should undergo cholecystectomy early, preferably before discharge.

  • Following a second episode of AP with no identifiable cause, in patients fit for surgery, we suggest performing a cholecystectomy to reduce the risk of recurrent episodes of AP.

Episoder(387)

Episode 361: 260. METHODS MONDAY-- EVENT RATE

Episode 361: 260. METHODS MONDAY-- EVENT RATE

Methods Monday  --- Accuracy of Event Rate and Effect Size Estimation in Major Cardiovascular Trials: A Systematic Review | Cardiology | JAMA Network Open | JAMA Network  During the design of a random...

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Episode 360: 259. Urinary Retention Evaluation and Catheterization Algorithm for Adult Inpatients

Episode 360: 259. Urinary Retention Evaluation and Catheterization Algorithm for Adult Inpatients

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2821168A team of researchers set out to change that by developing a comprehensive algorithm.The process involved a multidisciplinary panel ...

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Episode 359: 258. Oral Antibiotics and Risk of Serious Cutaneous Adverse Drug Reactions

Episode 359: 258. Oral Antibiotics and Risk of Serious Cutaneous Adverse Drug Reactions

https://jamanetwork.com/journals/jama/article-abstract/2822097Design, Setting, and Participants  Nested case-control study using population-based linked administrative datasets among adults aged 66 ye...

3 Jan 20255min

Episode 358: 257. Twice-Yearly Lenacapavir or Daily F/TAF for HIV Prevention

Episode 358: 257. Twice-Yearly Lenacapavir or Daily F/TAF for HIV Prevention

https://www.nejm.org/doi/full/10.1056/NEJMoa2407001ConclusionsNo participants receiving twice-yearly lenacapavir acquired HIV infection. HIV incidence with lenacapavir was significantly lower than bac...

30 Des 20246min

Episode 357: 256. Medications for alcohol-use disorder and follow-up after hospitalization

Episode 357: 256. Medications for alcohol-use disorder and follow-up after hospitalization

Allaudeen N et al. Medications for alcohol-use disorder and follow-up after hospitalization for alcohol withdrawal: A multicenter study. J Hosp Med 2024 Dec; 19:1122. (https://doi.org/10.1002/jhm.1345...

27 Des 20245min

Episode 356: 255. Real-world use of glucocorticoids for adults hospitalized with community-acquired pneumonia

Episode 356: 255. Real-world use of glucocorticoids for adults hospitalized with community-acquired pneumonia

Real‐world use of glucocorticoids and clinical outcomes in adults hospitalized with community‐acquired pneumonia on medical wards - Malecki - 2024 - Journal of Hospital Medicine - Wiley Online Library...

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Episode 355: 254. 2024 ESC Guidelines for the management of elevated blood pressure and hypertension

Episode 355: 254. 2024 ESC Guidelines for the management of elevated blood pressure and hypertension

2024 ESC guidelines propose a simple new BP categorization: Non-elevated: less than 120/70 mm Hg in the office (pharmacological treatment is not recommended). Elevated: 120 to 139/70 to 89 mm Hg (phar...

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Episode 354: 253. Centralized Colorectal Cancer Screening Outreach in Federally Qualified Health Centers

Episode 354: 253. Centralized Colorectal Cancer Screening Outreach in Federally Qualified Health Centers

Question  Does adding centralized mailed fecal immunochemical testing and patient navigation to usual care improve colorectal cancer (CRC) screening in US federally qualified health centers? pragmatic...

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