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Intern Inpatient Journal Club

02/07/2012 - Effect of intravenous omeprazole on recurrent bleeding after endoscopic treatment of bleeding peptic ulcers.

posted Feb 6, 2012, 2:20 PM by David de Gijsel   [ updated Feb 6, 2012, 2:20 PM ]

This paper established the role of one of the many 'standards of care' we all take for granted: the PPI infusion in patients with an upper GI bleed. 

10/25/2011 - Early goal-directed therapy in the treatment of severe sepsis and septic shock

posted Oct 24, 2011, 8:26 AM by Chief Resident   [ updated Oct 24, 2011, 8:26 AM by David de Gijsel ]

You've all probably heard of early goal-directed therapy in sepsis, so we'll take a look the original paper from the NEJM that established the concept.

10/11/2011 - A Comparison of Rate Control and Rhythm Control in Patients with Atrial Fibrillation

posted Oct 10, 2011, 1:54 PM by Chief Resident   [ updated Oct 10, 2011, 1:54 PM by David de Gijsel ]

Weiler usually offers more cardiac cases than Moses, since we have many more telemetry beds here. Hence, we thought that you might enjoy some cardiac literature to go with this: tomorrow, we'll take a look at the AFFIRM trial, the original study that compared rate control to rhythm control in patients with atrial fibrillation.

09/26/2011 - Effect of hydroxyurea on the frequency of painful crises in sickle cell anemia.

posted Oct 10, 2011, 1:41 PM by Chief Resident   [ updated Oct 10, 2011, 1:41 PM by David de Gijsel ]

This week, we'll take a look at the treatment of sickle cell anemia. You've all had your share of patients with sickle cell crises, I suppose. I know that some of you only knew this disease from the text book before you came to Monte. As with many diseases, the subset of patients you encounter in the hospital is quite different from the average patient that's affected and often times, they're quite challenging to manage. To balance your view on sickle cell anemia, we picked an article that presents a major breakthrough in the treatment of this disease. 

The attached paper 'Effect of hydroxyurea on the frequency of painful crises in sickle cell anemia' is the original RCT that established the efficacy of this treatment. I also attached a second paper, 'The risks and benefits of long-term use of hydroxyurea in sickle cell anemia', which is a follow-up study of the original cohort, but for journal club, we'll focus on the first one.

09/19/2011 - Associations between end-of-life discussions, patient mental health, medical care near death, and caregiver bereavement adjustment.

posted Oct 10, 2011, 1:37 PM by Chief Resident   [ updated Oct 10, 2011, 1:37 PM by David de Gijsel ]

By now, you've probably all found yourself taking care of very sick patients with a poor prognosis. Especially early on in your careers, it can be very challenging to determine what the best course in these situations is. How do you balance your role as the primary provider, who wants to do everything necessary or possible for the patient, with your sense of futility, harm or hopelessness? And how do patients and their caregivers really feel in these situations?

09/05/2011 - Does this patient have ascites? How to divine fluid in the abdomen

posted Oct 10, 2011, 1:27 PM by Chief Resident   [ updated Oct 10, 2011, 1:27 PM by David de Gijsel ]

We'll read the attached paper on the physical exam of ascites.

We picked the paper as an introduction to the excellent JAMA series The Rational Clinical Exam. It should help you realize the importance and power of physical findings in your everyday practice; detecting ascites is one of the remaining clinical dilemma's that might have immediate consequences for the management of your patient yet the confirmatory test (ultrasound) is not always readily available.

08/22/2011 - Assessment of patients' competence to consent to treatment

posted Oct 10, 2011, 1:20 PM by Chief Resident   [ updated Oct 10, 2011, 1:20 PM by David de Gijsel ]

We'll discuss the attached paper on the assessment of a patient's capacity to consent. You've all probably come across this problem and we hope that  this article will help you in the care of your patients.

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