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Routine electrocardiograms (ECGs) to measure QTc are not recommended prior to intravenous administration of ondansetron in hospitalized patients without high risk factors for arrhythmias.
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Ondansetron is a 5-HT3 receptor antagonist widely used in the hospital setting for the management of nausea and vomiting. Although it has been associated with QTc interval prolongation, the actual risk of clinically significant adverse events, such as torsades de pointes (TdP), is low. Despite this, many physicians routinely order ECGs before administering intravenous ondansetron due to concerns about its cardiovascular safety. The QTc represents the duration of ventricular repolarization and ...
ver más ... 2024Routine glucose testing is not recommended in newborns without risk factors solely because of jittery movements.
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During intrauterine life, the fetus maintains stable glucose levels through placental delivery. After birth, glucose levels decrease physiologically, reaching a nadir of 25–30 mg/dL in the first few hours, followed by a progressive increase over the next 48–72 hours. Neonatal hypoglycemia is defined variably according to pediatric guidelines, with the American Academy of Pediatrics (AAP) establishing thresholds of 40–45 mg/dL depending on postnatal age. The AAP recommends screening for ...
ver más ... 2024Routine discontinuation of anticoagulation is not recommended in older adults with atrial fibrillation (AF) and high risk of falls.
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Population aging has led to an increase in the prevalence of AF, especially in patients over 65 years of age. AF increases the risk of stroke fivefold, and anticoagulation reduces this risk in high-risk patients according to the CHA₂DS₂-VASc score. However, older adults are also at high risk of falls, with 25% experiencing at least one fall per year and 10% suffering serious injuries. Fear of intracranial hemorrhage (ICH) in anticoagulated patients is one of the main reasons for ...
ver más ... 2024Routine renal ultrasound is not recommended in hospitalized patients with acute kidney injury (AKI) without high-risk factors for urinary obstruction.
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Acute kidney injury (AKI) is a common complication in hospitalized patients, with an incidence of 13% to 22% during hospitalization. The etiology of AKI is divided into three main categories: prerenal, intrinsic, and postrenal. Most hospitalized cases are of prerenal or intrinsic origin, while urinary obstruction accounts for only 5% to 10% of cases. Despite this, renal ultrasound (RUS) is frequently requested to evaluate the presence of hydronephrosis in patients with AKI. It has been argued ...
ver más ... 2024Cefdinir is not recommended for the empiric treatment of common infections, such as community-acquired pneumonia (CAP), acute otitis media (AOM), acute bacterial sinusitis (ABS), streptococcal ...
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Cefdinir, an orally administered third-generation cephalosporin, has been widely used in the treatment of common community-based bacterial infections. However, its effectiveness is lower than that of other available options, which has led to questions about its routine use. Although cefdinir belongs to the same class of antibiotics as ceftriaxone, its spectrum of activity is more limited. In community-acquired pneumonia (CAP), acute otitis media (AOM), and acute bacterial sinusitis (ABS), ...
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