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Choosing Wisely ® : Things we do for no reason

Choosing Wisely ®: Things we do for no reason

Potassium is a highly regulated intracellular cation with serum concentrations maintained between 3.5 and 5.0 mmol/L.1 Deviations from this range impact cardiac function by altering physiologic membrane potential. Hyperkalemia (concentration >5.0 mmol/L) has depolarizing effects on myocytes, increasing the risk of cardiac arrhythmia. With increasing potassium levels, there is loss of P waves, development of sine-wave pattern conduction, atrioventricular (AV) junction delay, and ultimately ...

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 ...

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 ...

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 ...

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 ...