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Co-administration of furosemide-albumin is not recommended in patients with resistance to diuretics.


Choosing Wisely ® : Things we do for no reason

Choosing Wisely ®: Things we do for no reason


Diuretic resistance is defined as urine output of <100–150 mL/h during the first 6 h after loop diuretic administration. Two proposed mechanisms explain why albumin infusion preceding furosemide (hereon referred to as “coadministration”) might facilitate diuresis and/or overcome resistance. The first mechanism, based onpharmacokinetics, postulates that albumin binds furosemide so tightly that it prevents filtration in the glomerulus. Instead, the nephron actively secretes furosemide into ...

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The diagnostic and treatment of vitamin B12 deficiency is not recommended in adults over 16 years of age.


NICE

NICE


Vitamin B12 deficiency is caused by a lack of the vitamin in the diet or problems with absorption in the gastrointestinal tract (for example, due to autoimmune gastritis or major gastric resection). Vitamin B12 deficiency is usually diagnosed and treated in primary care. A blood test is usually done when people have symptoms such as unexplained fatigue, which can be common in many conditions, or when there are abnormal results on other blood tests. Testing is also performed when investigating ...

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Continuous monitoring and further laboratory testing is recommended instead of ECG in patients with mild hyperkalemia at risk for rapid potassium increases or dangerous arrhythmias.


Choosing Wisely ® : Things we do for no reason

Choosing Wisely: Things we do for no reason


Hyperkalemia in this context is associated with increased all-cause mortality Cardiac toxicity and arrhythmia are feared complications of hyperkalemia and a retrospective study from 2017 showed that ECG changes in patients with potassium >6.5 mmol/L predict the risk of short-term adverse cardiac events. Hyperkalemia in this context is associated with increased all-cause mortality. Pseudohyperkalemia, a false elevation in measured potassium levels most frequently caused by cellular lysis ...

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It is recommended to carry out a thorough examination of the person with intellectual and developmental disabilities who present a behavioral alteration or discomfort to avoid diagnostic ...


Essencial: Afegint valor a la pràctica clínica [Essencial: Adding value to the clinical practice]

Essencial Salud


Diagnostic overshadowing or diagnostic masking is a phenomenon by which health professionals attribute a physical or behavioral symptom to intellectual and developmental disability, without considering other factors. Although the concept was originally applied to people with intellectual and developmental disabilities, this bias affects other groups, to which the use of the term is being extended. To prevent diagnostic masking from occurring, the guidelines recommend that the health ...

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There are limited benefits of routine viral testing in EDs for adult patients with acute respiratory infection (ARI).


Less Is More Collection - JAMA Network

JAMA Network


In this systematic review and meta-analysis of 11 randomized clinical trials, rapid viral testing was not associated with reduced antibiotic use, ED length of stay, and the rate of ED return visits or of hospitalization. However, rapid viral testing was associated with moderately increased influenza antiviral use (absolute risk difference 1%) and decreased use of chest radiography and blood tests (absolute risk difference, 3%-4% each). Preferred Reporting Items for Systematic Reviews and ...

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