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)”
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)”
The Berlin definition, proposed in 2012, breaks with tradition by establishing three risk strata that are based on the degree of hypoxemia as assessed at a minimum positive end-expiratory pressure (PEEP).
Continue reading “Berlin Definition of the Acute Respiratory Distress Syndrome (ARDS)”
Acute cholecystitis is a very common complication of cholelithiasis, and as such is frequently encountered in surgical practice. TG07 diagnostic criteria are recognized as those to be recommended in current care for acute cholecystitis.
Continue reading “Diagnosis and Determination of Severity of Acute Cholecystitis”
The use of the Alvarado scoring system, which includes clinical examination findings and laboratory values, is helpful in ruling out appendicitis. Scores range from 1 to 10, with higher scores indicating a greater risk of appendicitis. When the score is less than 4, appendicitis is uncommon, and imaging and other interventions can be avoided.
Continue reading “Alvarado Score for Acute Appendicitis”
Recently developed consensus functional definitions on the basis of specific changes in the serum creatinine concentration and urine volume now complement anatomical approaches to diagnosis.
Continue reading “Classifications of Acute Kidney Injury and Chronic Kidney Disease”