A cost-effective diagnostic workup of patients with possible acute viral hepatitis is the most reasonable approach. Because 75% of cases of acute viral hepatitis result from infection with either HAV or HBV, the initial laboratory investigation should include serologic tests to exclude HAV or HBV. If the results of these studies are negative, further testing should be done to rule out acute HCV infection, which is less common. Serum HCV RNA is detectable 1 to 2 weeks after the onset of infection, whereas anti-HCV can be detected 8 to 10 weeks following infection with the virus. In clinically stable patients, waiting and checking the presence of antibodies to HCV may be plausible. Checking for HCV RNA by polymerase chain reaction in all patients is not cost-effective, unless there is a known history of blood exposure. Finally, not all acute hepatitis is viral. If the initial evaluation fails to show viral hepatitis, then other causes of hepatitis, such as alcoholic hepatitis, drug toxicity, autoimmune hepatitis, or Wilson’s disease, should be considered. Continue reading “Cost-Effective Laboratory Evaluation of Acute Viral Hepatitis”
Kidney Disease Improving Global Outcomes (KDIGO) guidelines address the definition, classification, and management of acute kidney injury (AKI) and chronic kidney disease (CKD). Continue reading “KDIGO Criteria for Acute Kidney Injury (AKI)”
In the Emergency Department, the diagnosis of acute myocardial infarction (AMI) relies initially on a patient’s history and the 12-lead electrocardiogram (ECG). Establishing the diagnosis of AMI in the left bundle branch block (LBBB) is difficult and can result in delay of definitive treatment. In 1996, Sgarbossa found 3 ECG criteria to evaluate for AMI in patients with LBBB. Continue reading “Criteria for Acute Myocardial Infarction in the Left Bundle Branch Block”
The classification or index of heart failure severity in patients with acute myocardial infarction (AMI) was proposed by Killip and Kimball aiming at assessing the risk of in-hospital death and the potential benefit of specific management of care provided in Coronary Care Units (CCU). Continue reading “Killip-Kimball Classification for Acute Myocardial Infarction”
Severe acute respiratory syndrome (SARS) is a viral respiratory illness caused by a coronavirus, called SARS-associated coronavirus (SARS-CoV). Continue reading “Case Definition for Severe Acute Respiratory Syndrome (SARS)”
Hypertensive disorders are common during pregnancy and can be classified into four pregnancy-associated categories: (1) chronic hypertension, (2) gestational hypertension, (3) preeclampsia, and (4) chronic hypertension with superimposed preeclampsia. In addition, non-pregnancy associated hypertensive emergencies can occur in the pregnant patient. Continue reading “Acute Hypertensive Definitions in the Pregnant Patient”
The diagnostic criteria for acute cholecystitis have high sensitivity (91.2%) and specificity (96.9%) and good diagnostic yield; therefore, their use as the diagnostic criteria for acute cholecystitis is recommended.
Continue reading “Diagnostic Criteria and Severity Grading of Acute Cholecystitis (TG18)”
This guideline provides global, evidence-informed recommendations on a number of specific issues related to the management of severe acute malnutrition in infants and children, Continue reading “Management of Severe Acute Malnutrition in Infants and Children”
The diagnostic and severity grading criteria on the 2018 Tokyo Guidelines (TG18) are used worldwide as the primary standard for management of acute cholangitis (AC). Continue reading “TG18/TG13 Diagnostic Criteria for Acute Cholangitis”
The changes improve the diagnosis of ARF among moderate/high-risk populations and re-establish the Jones criteria as the international gold standard for ARF diagnosis.
Continue reading “The 2015 Jones Criteria for Acute Rheumatic Fever (ARF)”